Weaning from mechanical ventilation (MV) accounts for a significant portion of the total MV duration, and failure to extubate or delayed extubation increases complications (particularly Ventilator-Associated Pneumonia (VAP)) and mortality. Standard tests (T-piece, Spontaneous Ventilation with Inspiratory Assistance (SV-IA)) have not demonstrated clear superiority, and the T-piece is still widely used despite its limitations. High-flow oxygen (HFO) may reduce ventilatory work and facilitate secretion clearance; however, there is a lack of physiological data in humans with an endotracheal tube in place. This study aims to address this gap prior to a subsequent clinical evaluation.
An experimental, prospective, single-center, 3-period crossover study with randomized sequence order and single-blind design (primary endpoint assessment and statistical analysis were conducted in a blinded manner).
Inclusion Criteria:
Adult patient, of legal age
On invasive mechanical ventilation for more than 48 hours
With at least one criterion indicating a high risk of extubation failure:
Capable of undergoing a mechanical ventilation weaning test ("weaning criterion"):
Respiratory rate < 35 bpm
Adequate oxygenation:
Effective cough
Patient is alert (RASS score -2 to +1), without sedation
Hemodynamically stable or on the minimum effective dose
Patient has an invasive arterial pressure catheter for arterial blood sampling
Informed consent signed by a family member
Patient is enrolled in or eligible for a social security program
Exclusion Criteria:
T piece follow by HFO follow by PSV
T piece follow by PSV follow by HFO
PSV follow by HFO follow by T piece
PSV follow by T piece follow by HFO
HFO follow by T piece follow by PSV
HFO follow by PSV follow by TP
High Flow Oxygen During Spontaneous Breathing Trial in Patients With High Weaning Risk Failure: Impact on the Weaning Course at D7 From the First Spontaneous Breathing Trial.
Effect of High Flow Oxygen Therapy in Spontaneous Breathing Trial on Weaning in Mechanical Ventilated Patients
Physiological Effect High-flow Tracheal Oxygen on Viscosity of Airway Mucus and Respiratory Effort in Patients Weaning from Invasive Mechanical Ventilation
Determination of the Optimal Spontaneous Breathing Trial During Weaning of Mechanical Ventilation
Physiologic and Clinical Effect of High-flow Oxygen Therapy in Tracheostomized Patients With Prolonged Mechanical Ventilation Undergoing Weaning Trials
High Flow During Weaning From Mechanical Ventilation
High Flow Oxygen VERSUS Non Invasive Ventilation Associated to Automated Flow Oxygen Titration After Patient Extubation
Ventilation Strategies During Spontaneous Breathing Trial