Comparing Liberal and Restrictive Intubation Strategies for Adults With Acute Hypoxemic Respiratory Failure in Intensive Care

What this Trial Is About

Acute hypoxemic respiratory failure often requires endotracheal intubation and invasive mechanical ventilation in about 30-40% of cases due to severe low oxygen levels or signs of respiratory distress. The main goals of invasive ventilation are to reduce breathing effort and improve oxygen supply. However, this approach can cause complications such as circulatory problems, muscle weakness, lung injury from the ventilator, and infections. This study aims to compare two intubation strategies to find the best balance between early intubation risks and ventilator-related harms in patients with this condition. The trial compares a liberal intubation strategy, where intubation is recommended if oxygen levels measured by SpO2FiO2 fall below 110 for more than 5 minutes or if restrictive criteria occur, with a restrictive strategy that recommends intubation only when more severe signs such as respiratory distress, very low oxygen levels below 88, neurological issues, or unstable blood circulation persist for over 5 minutes. Participants are randomly assigned to one of these two approaches to evaluate which better manages treatment risks and benefits. Participants will be monitored up to 28 days after enrollment to assess outcomes such as the duration of organ support considering survival, rates and timing of intubation, severity of organ failure, care duration, and adverse events related to the procedures and ventilation. Additional assessments include quality of life at day 90 and lung volume measurements by electrical impedance tomography at 1, 24, and 48 hours. Continuous monitoring will capture immediate and long-term effects of the intubation strategy under study.

IntHyx : Intubation Strategies for Patients With Acute Hypoxemic Respiratory Failure