High-flow Nasal Cannula Oxygen Therapy With or Without NIV During the Weaning Period

High-flow Nasal Cannula Oxygen Therapy With or Without Non-invasive Ventilation (NIV) During the Weaning Period: a Multicenter Randomized Controlled Trial

Prospective multicenter randomized controlled open-label trial comparing 2 strategies of oxygenation during the post-extubation period in ICU patients at high risk of extubation failure. Patients will be randomized and assigned to one of the two groups, with a 1:1 ratio.

Inclusion Criteria:

• Duration of mechanical ventilation prior to extubation at least 24h
• Planned extubation decided by the physician in charge of the patient after success of a weaning trial
• Patients at high risk of reintubation according to the following criteria: patients older than 65 years, or those having any underlying chronic cardiac or lung disease.

Exclusion Criteria:

• Patient admitted for traumatic brain injury
• Periphal neuromuscular disease as reason for intubation
• Usual lon-term treatment with NIV for chronic desease
• Usual lon-term treatment with CPAP for obstructive apneas syndrome
• Contraindication to NIV
• Unplanned extubation
• Do-not-reintubated order at time of extubation
• Terminal extubation for end of life
• People under legal protection
• Opposition to participate