Best starting flow for high-flow nasal cannula after extubation

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a single-center, randomized, 4-arm parallel-group trial comparing four HFNC flow-setting strategies after planned extubation: fixed 40 L/min, fixed 60 L/min, a peak tidal inspiratory flow (PTIF)-guided setting (5 L/min above PTIF up to 60 L/min), and a PaO2/FiO2 (P/F)-guided tiered flow (60/50/40 L/min by P/F ranges). Eligible adult patients have been mechanically ventilated >24 hours, passed a spontaneous breathing trial, and have PaO2/FiO2 <350 mmHg at extubation. The trial will collect physiological measures including PTIF and end-expiratory lung volume (EELV) and track extubation outcomes such as need for reintubation. The goal is to determine whether physiology-guided or simple fixed-flow approaches lead to better post-extubation results and tolerability.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Intubated and receiving mechanical ventilation for more than 24 hours
* Ready for planned extubation after passing a spontaneous breathing trial
* PaO2/FiO2 \<350 mmHg on the day of extubation

Exclusion Criteria:

* Age \<18 years
* On do-not-reintubate code
* Pregnant women
* Having tracheostomies
* Infeasibility of using HFNC
* Planning to use preventive NIV after extubation by the primary care team
* Life expectancy less than one month

Where it's running

• National Taiwan University Hospital
  Taipei, Taiwan Recruiting

Study contacts

• Study coordinator: Sheng-Yuan Ruan, MD, PhD
• Email: syruan@ntu.edu.tw
• Phone: 886223123456

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.