Comparing Protocolized and Standard Care HFNC Weaning Using ROX Index in Adults with Acute Respiratory Failure

What this Trial Is About

Researchers are evaluating different methods for discontinuing high-flow nasal cannula HFNC respiratory support in adults with acute respiratory failure ARF. This study compares a standardized HFNC weaning strategy using specific thresholds of the ROX index and fraction of inspired oxygen FiO2 with usual clinical practice based on physician judgment. The goal is to better predict successful weaning and reduce risks of respiratory deterioration or prolonged hospital stays. Participants will be randomly assigned to one of two groups a protocolized weaning group where HFNC discontinuation is guided by ROX index 9.2 and FiO2 40%, or a usual care group where weaning decisions rely on physician clinical judgment without a fixed protocol. The study tracks the process of HFNC discontinuation and monitors respiratory support requirements closely. During the study, participants will be assessed for weaning success or failure within 48 hours after HFNC discontinuation. Researchers will also monitor length of hospital stay, mortality rates, diaphragmatic function through ultrasound, and predictors of weaning success and HFNC treatment duration. The study involves regular clinical evaluations and follow-up during hospitalization, with total monitoring extending up to 60 days for some outcomes.

Effect of High Flow Nasal Therapy (HFNC) Weaning Protocols vs Standard of Care on Respiratory Outcomes in Patients With Acute Respiratory Failure