Although many studies have investigated the clinical benefits of nasal high flow during acute hypoxemic respiratory failure, there is no data (and even less so recommendations) on how to best conduct this technique, including its initiation and its weaning periods. Investigators will assess in a multicenter, observational study, the way clinicians use nasal high flow therapy in patients with acute respiratory failure in order to try identify one or more strategies that may be then compared in an interventional study.
Nasal high flow oxygen therapy is increasingly used as a first-line treatment for hypoxemic acute respiratory failure, because of its remarkable tolerance (in comparison with NIV) and its physiological effects (nasopharyngeal dead space washout, positive end-expiratory pressure effect with possible alveolar recruitment, better matching with the patient's inspiratory flow, more reliable and adjustable FiO2); that together contribute to a reduction in respiratory workload and better oxygenation. Although many studies have investigated the clinical benefits of nasal high flow during acute hypoxemic respiratory failure, there are no data (and even less recommendations) on how to best conduct this technique, including its initiation and its weaning periods. Because different approaches exist among clinicians, investigators believe that a multicenter observational study that would collect data regarding the different ways high flow is conducted in patients with acute respiratory failure is necessary before performing an interventional study that would test and compare different strategies in order to answer the question: what are the best strategies (in terms of flow and FiO2 settings) to initiate and to wean high-flow oxygen therapy in patients with acute respiratory failure? Investigators will assess in a multicenter, observational study, the way clinicians use nasal high flow therapy in patients with acute respiratory failure in order to try identify one or more strategies that may be then compared in an interventional study.
Study Type
OBSERVATIONAL
Enrollment
100
Service de Réanimation Médico-Chirurgicale
Colombes, France
RECRUITINGService de Réanimation Médicale
Dijon, France
RECRUITINGService de Réanimation Médicale
values of gas flow over time (in liters per minute)
values of gas flow set on the device of nasal high flow will be monitored over time so as to describe how physicians set and modify this parameter during treatment with nasal high flow
Time frame: entire duration of high flow therapy (5 to 7 days)
values of fraction in inspired oxygen (FiO2) over time (between 0.21 and 1.0)
values of FiO2 set on the device of nasal high flow will be monitored over time so as to describe how physicians set and modify this parameter during treatment with nasal high flow
Time frame: entire duration of high flow therapy (5 to 7 days)
respiratory rate (breath per minute)
values of respiratory rate upon initiation of nasal high flow and at each change of nasal high flow parameters (gas flow or FiO2) will be monitored.
Time frame: entire duration of high flow therapy (5 to 7 days)
pulse oximetry (SpO2) (percentage)
values of oxgen saturation upon initiation of nasal high flow and at each change of nasal high flow parameters (gas flow or FiO2) will be monitored.
Time frame: entire duration of high flow therapy (5 to 7 days)
values of the Respiratory rate Oxygenation indeX ("ROX") index defined as the ratio of pulse oximetry over fraction of inspired oxygen to respiratory rate
values of the "ROX" index will be monitored at different time points (2, 6 and 12 hours after nasal high flow therapy initiation)
Time frame: 12 hours
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Grenoble, France
Service de Réanimation
Longjumeau, France
RECRUITINGService de Réanimation
Orléans, France
RECRUITINGService de Réanimation Médicale et Resiratoire
Paris, France
RECRUITINGService de Réanimation Médicale
Paris, France
RECRUITINGService de Réanimation
Poitiers, France
RECRUITINGService de Réanimation Médicale
Rouen, France
RECRUITINGService de Réanimation Médicale
Tours, France
RECRUITING