Please select the eligibility criteria that correspond to the clinical trial below.
Title: High Flow Nasal Therapy Versus Noninvasive Ventilation in Mild to Moderate Acute Hypercapnic Respiratory Failure: A Non-inferiority Randomized Trial
Brief Summary: Randomized multicenter non-inferiority trial comparing High flow nasal therapy (HFNT) versus Noninvasive ventilation (NIV) in patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure.


Options:
A: Inclusion Criteria:

* Presence of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure;
* 7.25 \< pH \< 7.35;
* Arterial Partial pressure of carbon dioxide (PaCO2) equal or greater than 55 mmHg;
* Age \> 18 years/old

Exclusion Criteria:

* Invasive mechanical ventilation in the last 60 days
* Use of any form of noninvasive ventilation or high flow oxygen through nasal cannula (HFNT) prior to study enrollment after the onset of acute hypercapnic respiratory failure (AHRF);
* Noninvasive home care ventilation;
* Unstable clinical condition (need for vasopressors for \>24 h, acute coronary syndrome or life-threatening arrhythmias);
* Refusal of treatment;
* Agitation (RASS \>= +2) or non-cooperation (Kelly Matthay \>=5);
* Failure of more than two organs;
* Cardiac arrest;
* Respiratory arrest requiring tracheal intubation;
* Recent trauma or burns of the neck and face;
* Pregnancy;
* Refusal of consent;
* Inclusion in other research protocols.
B: Inclusion Criteria:

* Patients after cardiac/thoracic surgery with acute respiratory failure defined by the presence of the following criteria:

  * report PaO2/FiO2 \<300
  * Respiratory rate\> 25 for at least 2 hours
  * Getting involved accessory respiratory muscles
  * paradoxical breathing Or
* In immediate after extubation, the patient will be eligible if present in the withdrawal test:

  * SaO2 \<90% in 12 L of O2 during a trial of spontaneous ventilation tube on
  * PaO2 \<10 kPa at a FiO2 ≥ 50% during a VS trial + pressure support
  * The presence of a risk factor: Obesity (BMI\> 30), FEVG \<40%, Failed extubation prior, stridor

Exclusion Criteria:

* Previous history of SAS
* Patient tracheotomy
* Comas non hypercapnic
* bradypnea
* Cardiac arrest
* Gastric Surgery recent
* Restlessness, lack of cooperation
* Nausea, vomiting
* Hemodynamic instability
C: Inclusion Criteria:

* Planned or unplanned surgical procedures
* Abdominal or abdominal and thoracic surgery
* Expected duration ≥2 hours
* ARISCAT score ≥26 points

Exclusion Criteria:

* Age \<18 years
* Body mass index \>35 kg/m2
* Sleep apnea syndrome
* Patient refusal
* Pregnancy and/or lactation
D: Inclusion Criteria:

* Known immunosuppression defined as one or more of the following: (a) immunosuppressive drug or long-term \[\>3 months\] or high-dose \[\>0.5 mg/kg/day\] steroids; (b) solid organ transplantation; (c) solid tumour; (d) haematological malignancy.
* ICU admission for any reason
* Need for oxygen therapy ≥6 Liters/min defined as one or more of the following: (a) respiratory distress with a respiratory rate \>30/min; (b) cyanosis; (c) laboured breathing; (d) SpO2\<90%; and (e) expected respiratory deterioration during a procedure
* Written informed consent from the patient or proxy (if present) before inclusion or once possible when patient has been included in a context of emergency.

Exclusion Criteria:

* Patient admitted to the ICU for end-of-life care. Do-not-intubate (DNI) patients can be included.
* Refusal of study participation or to pursue the study by the patient
* Hypercapnia with a formal indication for NIV \[PaCO2 ≥ 50 mmHg, formal indication for NIV\]
* Isolated cardiogenic pulmonary oedema \[formal indication for NIV\]. Patients with pulmonary oedema associated with another ARF etiology can be included.
* Pregnancy or breastfeeding
* Anatomical factors precluding the use of a nasal cannula
* Absence of coverage by the French statutory healthcare insurance system
* Post surgical setting from D1 to D6

After discussion at the investigator meeting and based on comments from the Data and Safety Monitoring Board on May 12, 2016, as all included patients need to have an acute hypoxemic respiratory failure and at least 6l of oxygen per minute, patients admitted to the ICU to secure any procedure (bronchoscopy etc..) or those not admitted for acute respiratory failure and who undergo intubation, will NOT be included in this trial. Only patients meeting criteria of acute respiratory failure will be included in this trial.

Answer: A