Comparing Face Mask CPAP, Noninvasive Ventilation, and High-flow Nasal Oxygen for Avoiding Intubation in Adults with Acute Hypoxemic Respiratory Failure

What this Trial Is About

Researchers are investigating the best non-invasive oxygen therapy to avoid intubation in adults with acute hypoxemic respiratory failure AHRF, a serious condition often requiring intensive care and invasive ventilation with high mortality. This randomized clinical trial compares three oxygen strategies continuous positive airway pressure CPAP, high-flow nasal oxygen HFNO, and non-invasive ventilation NIV to determine which improves intubation-free survival. Participants are randomly assigned to receive one of three treatments. The CPAP group receives face mask ventilation with carefully adjusted pressure and oxygen levels for at least 16 hours daily over 2 days, with breaks supported by HFNO. The HFNO group gets heated, humidified oxygen through nasal prongs continuously for at least 2 days. The NIV group receives face mask non-invasive ventilation combining pressure support and oxygen for at least 16 hours daily over 2 days, alternating with HFNO between sessions. During the study, researchers monitor survival without intubation over 28 days as the main outcome. They also assess mortality rates, intubation rates, discomfort levels, ventilator-free days, and hospital stay lengths. Patients are closely evaluated from randomization through hospital discharge, with data collected up to 60 days to understand treatment effects and safety. Participation lasts through these follow-up periods to capture important clinical outcomes.

Effects of Face Mask Continuous Positive Airway Pressure Vs. Noninvasive Ventilation Vs. High-flow Nasal Oxygen on Intubation-free Survival in Acute Hypoxemic Respiratory Failure: the TRIPOD Randomized Clinical Trial