NIV Versus HFO for Acute Exacerbations of Interstitial Lung Diseases

Evaluation of Physiological Effects of Noninvasive Mechanical Ventilation and High-flow Oxygen Therapy for Acute Exacerbations of Interstitial Lung Diseases

The objectives of this study are to compare the physiological consequences of high-flow oxygen therapy and noninvasive mechanical ventilation on ventilation, respiratory work and hemodynamics during acute respiratory failure in diffuse interstitial pneumonia.

Inclusion criteria:

• Age > 18 yrs
• Hospitalization in intensive care unit
• Acute exacerbation of a previously/presently documented diffuse (fibrotic) interstitial lung disease
• Dyspnea majoration since at least 1 month
• Alveolar or ground-glass opacities on CT-scan that are superposed to interstitial lung disease and not explained by left heart failure or volume overload
• Hypoxemia requiring oxygen flows > 6 L/min

Exclusion criteria:

• Contraindication to noninvasive ventilation or high-flow oxygen therapy
• Immediate indication to endotracheal intubation or hemodynamic assistance
• Body mass index > 40
• Presence of a pacemaker or an implantable defibrillator
• Presence of cutaneous lesions where Pulmovista® belt should be placed
• Moribund patient
• Pregnant or breastfeeding women or women of childbearing age without an effective method of contraception
• Protected adult patient (tutorship or curatorship)
• Patient deprived of liberty by court or administrative decision
• No possibility to install nasogastric tube
• Endotracheal or tracheostomy tube requirement during the study
• Hemodynamic assistance requirement during the study