Butare

This research aims to evaluate oxygen delivery methods for adult patients with acute hypoxemia in resource-limited hospitals in low or lower middle income countries. The study specifically compares high flow oxygen with standard flow oxygen to determine which method leads to lower mortality and better patient outcomes in these settings. It also seeks to identify challenges and facilitators for using high flow oxygen and to measure oxygen consumption differences between the two methods. Participants will be randomly assigned to one of two groups one receiving heated and humidified high flow oxygen delivered via nasal cannula at flows up to 60 liters per minute, and the other receiving standard flow oxygen through nasal cannula, face masks, or non-rebreather masks at flows up to 15 liters per minute. Both groups will follow protocols targeting oxygen saturation levels between 90 and 94. The study will take place in five hospitals and will monitor oxygen use and feasibility factors. During the study, participants will be monitored for in-hospital mortality up to 90 days, functional status, need for mechanical ventilation, duration of oxygen use, and lengths of hospital and ICU stay. Researchers will evaluate the time to any escalation of respiratory support. Data collection will include assessments of oxygen delivery, patient outcomes, and resource use, with the total observation period lasting 90 days after enrollment.