Investigating the timing of intubation in COVID-19 patients with respiratory failure

Effects of Early vs. Delayed Invasive Mechanical Ventilation: A Target Trial Emulation

Observational Erasmus Medical Center · NCT06757166

This study is trying to see if intubating COVID-19 patients earlier or later can lead to better health outcomes and lower risks of lung injury.

Quick facts

Study typeObservational
Enrollment50000 (estimated)
Ages18 Years and up
SexAll
SponsorErasmus Medical Center Academic / other
Locations1 site (Rotterdam, South Holland)
Trial IDNCT06757166 on ClinicalTrials.gov

What this trial studies

This observational study aims to evaluate the impact of early versus late endotracheal intubation on clinical outcomes in patients with SARS-CoV-2-related hypoxemic respiratory failure. It focuses on determining whether delaying intubation after non-invasive respiratory support increases the risk of lung injury and affects mortality rates. The study will analyze various thresholds for initiating intubation based on the patient's oxygenation and respiratory rate to identify optimal timing for intervention. By comparing different treatment regimes, the research seeks to improve patient outcomes related to invasive mechanical ventilation.

Who should consider this trial

Good fit: Ideal candidates include hospitalized adults aged 18 and older experiencing hypoxemic respiratory failure with an S/F ratio less than 250 who have not yet been intubated.

Not a fit: Patients with a do-not-intubate order or those who already have a tracheostomy will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved survival rates and reduced duration of invasive ventilation for COVID-19 patients.

How similar studies have performed: While the approach of investigating intubation timing is critical, similar studies have shown mixed results, indicating that this area remains an important and novel field of inquiry.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Hospitalized (inpatient or ICU)
* 18 years or older
* Hypoxemic respiratory failure: S/F\<250
* Not yet intubated

Exclusion Criteria:

* Do not intubate order
* Presence of tracheostomy

Where this trial is running

Rotterdam, South Holland

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Target Trial Emulation, Invasive Mechanical Ventilation
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.