Modified high flow tracheal oxygen-40L/minStandard high flow tracheal oxygen-40L/minT-pieceModified high-flow tracheal oxygen-60L/minStandard high-flow tracheal oxygen-60 L/min
Modified high flow tracheal oxygen-40L/min: Modified high-flow tracheal oxygen with a flow rate of 40L/min will be performed.
Standard high flow tracheal oxygen-40L/min: Standard high-flow tracheal oxygen with a flow rate of 40 L/min will be performed.
T-piece: T-piece will be performed.
Modified high-flow tracheal oxygen-60L/min: Modified high-flow tracheal oxygen with a flow rate of 60L/min will be performed.
Standard high-flow tracheal oxygen-60 L/min: Standard high-flow tracheal oxygen with a flow rate of 60 L/min will be performed.
Study summary
Spontaneous breathing trials (SBT) are essential for assessing extubation tolerance, yet optimal approaches are debated. High-flow nasal oxygen offers benefits like precise oxygen delivery, flow-related positive end-expiratory pressure generation and improved lung function. While high-flow tracheal oxygen can also be used as an SBT method, it has reduced physiological effects due to bypassing the upper airway with a more open circuit. To enhance this limitation, investigators developed a modified high-flow tracheal oxygen tube with a smaller expiratory end diameter to increase expiratory resistance and airway pressure. This is a prospective randomized crossover study that aims to compare the physiological effects of standard and modified high-flow tracheal oxygen versus T-piece during SBT.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Mechanical ventilation for more than 24 hours
2. Considered by the physicians for the readiness to wean and ready for spontaneous breathing trials
Exclusion Criteria:
1. Age younger than 18 years old
2. Pregnancy
3. Hemodynamic instability (mean arterial pressure \<60 mmHg, heart rate \>140 or \<60 bpm)
4. Respiratory and oxygenation instability (respiratory rate \> 35bpm or oxygen saturation measured by pulse oximetry \<90%)
5. Neuromuscular diseases or phrenic nerve injury
6. Recent trauma or surgery to the trachea, esophagus, neck, chest, or stomach
7. Pneumothorax or placement of a chest drainage
8. Contraindication to electrical impedance tomography (EIT) (implantable defibrillator)
9. Anticipating withdrawal of life support
Primary outcome measure(s)
Mean expiratory airway pressure — From enrollment to the end of treatment at 4 hours Mean expiratory airway pressure will be measured during standard and modified high-flow tracheal oxygen versus T-piece.
Positive end-expiratory pressure — From enrollment to the end of treatment at 4 hours Positive end-expiratory pressure will be measured during standard and modified high-flow tracheal oxygen versus T-piece.
Change of end-expiatory lung volume — From enrollment to the end of treatment at 4 hours Change of end-expiatory lung volume will be measured during standard and modified high-flow tracheal oxygen versus T-piece.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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