Comparison of Patient Work of Breathing and Tidal Volumes With High Flow Nasal Cannula Oxygen Therapy and NIV (Non-Invasive Ventilation) After Extubation in the ICU.

Poitiers University Hospital25 enrolled

Overview

This study is aimed at evaluating patient work of breathing and tidal volumes with three methods of oxygenation: standard oxygen, high-flow oxygen therapy and non-invasive ventilation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

ICU Extubation Non-invasive Ventilation High-Flow Nasal Oxygen Therapy Respiratory Effort Work of Breathing

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Minimum age: 18 years * planned extubation decided by the physician in charge of the patient after success of weaning trial * patients at high risk of reintubation according to the following criteria: patient older than 65 years, or those having any underlying chronic cardiac or lung disease * Hypoxemia defined by PaO2/FiO2 \< 300 mmHg under mechanical ventilation before extubation Exclusion Criteria: * Duration of mechanical ventilation prior to extubation \< 24h * Contraindication to NIV * Contraindication to nasogastric tube * Do-not-reintubated order at time of extubation * People under legal protection * Opposition to participate

Outcomes

Primary Outcomes

Patient respiratory effort and tidal volume (Vt)

Swing of oesophageal pressure and pressure-Time product measured by a nasogastric pressure sensor tidal Volume estimated by electric impedance tomography

Time frame: 1h20