Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
NCT07007715

Identifying the Best Flow Setting Strategy for High-Flow Nasal Cannula

Led by National Taiwan University Hospital · Updated on 2025-06-06

480

Participants Needed

1

Research Sites

160 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

The goal of this randomized trial is to compare four different flow-setting approaches for post-extubation use of high-flow nasal cannula (HFNC). Selecting the appropriate flow rate when initiating HFNC oxygen therapy is both crucial and challenging for clinicians, as the physiological benefits of HFNC depend significantly on the flow rate. To date, there are no guidelines or consensus on flow-rate setting and weaning for HFNC oxygen therapy. The investigators hypothesized that physiological marker-guided flow setting using peak tidal inspiratory flow (PTIF) or PaO₂/FiO₂ ratios lead to better extubation outcomes as compared to empirical flow setting of 40 L/min or 60 L/min. Participants will be randomly assigned to one of four study groups with different flow setting strategies summarized as follows: (1) Setting flow at 40 L/min, (2) Setting flow at 5 L/min above the peak tidal inspiratory flow, up to a maximum of 60 L/min. (3) Setting flow according to P/F ratio prior to extubation. Flow will be set at 60, 50 40 L/min if P/F ratio \<250 mmHg, 250-300 mmHg and \>300 mmHg, respectively. (4) Setting flow at 60 L/min.

CONDITIONS

Official Title

Identifying the Best Flow Setting Strategy for High-Flow Nasal Cannula

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Intubated and receiving mechanical ventilation for more than 24 hours
  • Ready for planned extubation after passing a spontaneous breathing trial
  • PaO2/FiO2 ratio less than 350 mmHg on the day of extubation
Not Eligible

You will not qualify if you...

  • Younger than 18 years
  • Have a do-not-reintubate order
  • Pregnant women
  • Have tracheostomies
  • Unable to use high-flow nasal cannula
  • Planning to use preventive noninvasive ventilation after extubation
  • Life expectancy less than one month

AI-Screening

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Trial Site Locations

Total: 1 location

1

National Taiwan University Hospital

Taipei, Taiwan

Actively Recruiting

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Research Team

S

Sheng-Yuan Ruan, MD, PhD

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

4

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