Validating the BREF models for estimating breathing effort in ICU patients on high-flow nasal oxygen.

External Validation of the BREF Models for Estimating the Breathing Effort During High-flow Oxygen Therapy

Istituto Clinico Humanitas · NCT06669312

This project tests whether BREF models can accurately estimate breathing effort from esophageal pressure recordings in adults in the ICU receiving high-flow nasal oxygen.

Quick facts

Study typeObservational
Enrollment250 (estimated)
Ages18 Years and up
SexAll
SponsorIstituto Clinico Humanitas (other)
Locations1 site (Rozzano, Milan)
Trial IDNCT06669312 on ClinicalTrials.gov

What this trial studies

This observational, single-center effort will externally validate the BREF predictive models by comparing model outputs to measured esophageal pressure swings (ΔPes) in adult ICU patients treated with high-flow nasal cannula. Patients who are already instrumented with an esophageal balloon as part of local clinical care will have ΔPes recordings collected and matched to the models' predictions. Enrollment excludes patients with chronic lung disease or cardiogenic pulmonary edema and requires inclusion within 96 hours of admission; no interventional therapy is applied by the protocol. The analysis will quantify model accuracy and generalizability to a routine ICU population.

Who should consider this trial

Good fit: Adults (≥18) in the ICU who are receiving high-flow nasal oxygen and have an esophageal balloon placed as part of routine care, without chronic lung disease or cardiogenic pulmonary edema and within 96 hours of admission.

Not a fit: Patients with chronic lung disease, cardiogenic pulmonary edema, those not instrumented with an esophageal balloon, or those admitted more than 96 hours earlier are unlikely to be eligible or to benefit from this validation.

Why it matters

Potential benefit: If validated, the models could give clinicians a simple bedside tool to detect strong breathing efforts earlier and help prevent respiratory or diaphragmatic injury.

How similar studies have performed: Prior research shows esophageal pressure swings correlate with inspiratory effort and HFNC can reduce intubation rates, but external validation of the BREF predictive models in routine ICU populations is limited, making this work relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion criteria:

* adult (≥18 years of age) patients in the ICU
* treated with high-flow oxygen delivered via nasal cannula
* equipped with an esophageal balloon as per local clinical practice.

Exclusion criteria:

* history of chronic lung disease
* cardiogenic pulmonary edema
* \>96 hours from admission to the participating unit.

Where this trial is running

Rozzano, Milan

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.

View on ClinicalTrials.gov →

Conditions: Acute Respiratory Failure, Oxygen Inhalation Therapy, Respiratory Distress, Acute respiratory failure, High-flow oxygen therapy, Esophageal pressure, P-SILI, Breathing effort

Last reviewed 2026-05-15 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.