Building Respiratory Support in East Africa Through High Flow Versus Standard Flow Oxygen Evaluation

NCT ID: NCT05754034

Last Updated: 2026-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-11

Study Completion Date

2026-12-31

Brief Summary

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Acute hypoxemia is common and deadly in resource variable settings. While studies in high income countries (HICs) have indicated a possible benefit to high flow oxygen as compared with standard flow oxygen, rigorous studies in low or lower middle income countries (LMICs) have not been performed. Studies in sepsis have demonstrated that interventions that improve outcomes in one context may actually be neutral or harmful in a different context.

The goal of this study is to test whether high flow oxygen results in better outcomes for hypoxemic adult patients, as compared with standard flow oxygen, in five LMIC hospitals. The main questions it aims to answer are:

1. For hypoxemic adults in these LMIC study settings, does high flow oxygen or standard flow oxygen result in lower mortality?
2. What are the facilitators and barriers to using high flow oxygen in these settings?
3. Does high flow or standard flow oxygen use more oxygen?

Participants will be randomized to receive either high flow oxygen through a large nasal cannula, or to receive standard flow oxygen, through nasal cannulas, face masks, or non-rebreather masks. Researchers will compare the outcomes for the two groups, to see if one group of patients has better outcomes than the other.

The study will also examine how much oxygen is used by the two patient groups, as well as other factors relevant to the feasibility of implementation of high flow oxygen in these sites.

Detailed Description

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Conditions

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Acute Hypoxemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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High flow oxygen

Heated and humidified oxygen delivered via high flow oxygen device through nasal cannula, up to 60 liters per minute of flow.

Group Type EXPERIMENTAL

High flow oxygen

Intervention Type DEVICE

humidified and heated oxygen delivered at high flow rates via nasal cannula, with protocol to target SpO2 90-94%

Standard flow oxygen

Oxygen delivered via standard oxygen devices at standard flows up to 15 liters per minute: nasal cannula, face mask, or nonrebreather mask.

Group Type ACTIVE_COMPARATOR

Standard flow oxygen

Intervention Type OTHER

oxygen delivered at standard flow rates via nasal cannula, facemask, or nonrebreather mask, with protocol to target SpO2 90-94%

Interventions

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High flow oxygen

humidified and heated oxygen delivered at high flow rates via nasal cannula, with protocol to target SpO2 90-94%

Intervention Type DEVICE

Standard flow oxygen

oxygen delivered at standard flow rates via nasal cannula, facemask, or nonrebreather mask, with protocol to target SpO2 90-94%

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* age\>=18 years AND
* admitted to a study site hospital within the 24 hours prior to screening AND
* SpO2\<90% at time of first assessment OR
* receiving oxygen at time of first assessment

Exclusion Criteria

* imminent death (high clinical suspicion of death within 24 hours of admission)
* patient or caregiver refusal of study participation
* history of chronic respiratory failure (SpO2\<90% or oxygen dependence for at least three months)
* anatomical factors precluding the use of nasal cannula
* intubation or non-invasive ventilation by the clinical team prior to screening for the trial
* known hypoxemia at transferring facility for \>48 hours
* lack of availability of either SFO or HFO devices or supplies at the time of randomization.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wellcome Trust

OTHER

Sponsor Role collaborator

Beth Israel Deaconess Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Elisabeth Riviello

Assistant Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elisabeth Riviello, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Beth Israel Deaconess Medical Center

Locations

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AIC Kijabe Hospital

Kijabe, , Kenya

Site Status RECRUITING

Nakuru Level V Hospital

Nakuru, , Kenya

Site Status RECRUITING

Queen Elizabeth Central Hospital

Blantyre, , Malawi

Site Status RECRUITING

The University Teaching Hospital of Butare (CHUB)

Huye, , Rwanda

Site Status RECRUITING

The University Teaching Hospital of Kigali (CHUK)

Kigali, , Rwanda

Site Status RECRUITING

Countries

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Kenya Malawi Rwanda

Central Contacts

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Elisabeth Riviello, MD, MPH

Role: CONTACT

+1 617 447 5131

Theogene Twagirumugabe, MD, PhD

Role: CONTACT

+250 788 539 904

Facility Contacts

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Nelly Kebeny, RN

Role: primary

Wanja Kageche, RN

Role: primary

Innocent Sulani, MBBS, MSc

Role: primary

Blaise Gahungu, MMed

Role: primary

Dona Fabiola, MMed

Role: primary

Other Identifiers

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222165/Z/20/Z

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2022P001102

Identifier Type: -

Identifier Source: org_study_id

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