Weaning Protocol for High Flow Nasal Cannula Oxygen Therapy (SLOWH)

Seoul National University

Status: Completed

Conditions: Respiratory Insufficiency; High Flow Nasal Cannula

Treatments: Device: FiO2 reduction first; Device: Flow reduction first; Device: Simultaneous (flow and FiO2) reduction

Study type: Interventional

Funder types: Other

Identifiers

NCT03845244

B-1809-492-006

Details and patient eligibility

About

High flow nasal cannula oxygen therapy has been widely used in critically ill patients. Despite effectiveness of high flow nasal cannula as a treatment, optimal methods to withdrawal high flow nasal cannula after recovery from preexisting conditions has not been investigated to date. In this study, we will evaluate the efficacy and safety of three different weaning methods in patients with high flow nasal cannula oxygen therapy.

Full description

Comparison of three weaning strategies: flow reduction first versus fraction of inspired oxygen (FiO2) first versus simultaneous reduction

Enrollment: 100 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The patients applying high flow nasal cannula and satisfying the following weaning criteria.

  1. Patient who has recovered from the underlying condition
  2. No signs of respiratory distress like agitation, diaphoresis or anxiety
  3. Arterial pH ≥ 7.35, SpO2 > 90% on FiO2 ≤ 0.5
  4. Respiratory rate ≤ 25/min, Heart rate ≤120/min, Systolic blood pressure ≥ 90mmHg

Exclusion criteria

• Severe hypercapnia (pH <7.25)
• Respiratory arrest requiring tracheal intubation
• Cardiac arrest, acute coronary syndrome or life threatening arrhythmias
• Failure of more than two organs
• Recent trauma or burns of the neck and face
• Non- cooperation
• Pregnancy
• Refusal of treatment

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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100 participants in 3 patient groups

Flow reduction first group

Active Comparator group

Description:

Flow reduction first -\> FiO2 reduction -\> conventional oxygen therapy

Treatment:

Device: Flow reduction first

FiO2 reduction first group

Active Comparator group

Description:

FiO2 reduction first -\> flow reduction -\> conventional oxygen therapy

Treatment:

Device: FiO2 reduction first

Simultaneous reduction group

Active Comparator group

Description:

Simultaneous (Flow and FiO2) reduction -\> conventional oxygen therapy

Treatment:

Device: Simultaneous (flow and FiO2) reduction