A Prospective Randomized Controlled Trial Comparing High-Flow Nasal Cannula Versus Noninvasive Ventilation on Reintubation and Post-Extubation Respiratory Failure in High-Risk Patients With Systolic Heart Failure

What this Trial Is About

This research aims to compare two breathing support methods after planned extubation in patients with systolic heart failure who need invasive mechanical ventilation. The study focuses on people who have a heart condition with an ejection fraction of 40% or less and are admitted to intensive care units. It seeks to find out which method better prevents the need for reintubation or respiratory failure after removing the breathing tube. Participants will be randomly assigned to one of two groups after planned extubation: one group will receive continuous therapy using high-flow nasal cannula (HFNC) for 24 hours at the highest tolerated flow level, and the other group will receive non-invasive ventilation (NIV) with set ventilator settings for 24 hours. The study will take place at the Yale New Haven Hospital and is open-label, meaning both patients and researchers know the assigned treatment. During the study, researchers will monitor the rates of reintubation or respiratory failure within 72 hours after extubation as the primary outcome. Additional assessments include rates of respiratory failure at different time points, patient tolerance to treatments, length of hospital stay, ICU and hospital mortality, time to reintubation, and oxygenation measurements. Participants will be closely observed during the first 24 hours of treatment and followed up to 30 days post-extubation to gather comprehensive data on outcomes and safety.

A Trial Comparing High-Flow Nasal Cannula Versus Noninvasive Ventilation on Reintubation and Post-Extubation Respiratory Failure in High-Risk Patients With Systolic Heart Failure