Please select the eligibility criteria that correspond to the clinical trial below.
Title: High-flow Nasal Cannula Oxygen Therapy With or Without Non-invasive Ventilation (NIV) During the Weaning Period: a Multicenter Randomized Controlled Trial
Brief Summary: Prospective multicenter randomized controlled open-label trial comparing 2 strategies of oxygenation during the post-extubation period in ICU patients at high risk of extubation failure. Patients will be randomized and assigned to one of the two groups, with a 1:1 ratio.


Options:
A: 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
B: Inclusion Criteria:

* Low Risk Patients:
* Any extubated patients after tolerating a spontaneous breathing trial.
* High Risk Patients:
* Any extubated patients after \>48 hours under mechanical ventilation and any of the following:
* \>65 years

  * cardiac failure as the primary indication of mechanical ventilation
  * COPD
  * APACHE II \>12 points the extubation day
  * BMI \>30
  * inability to manage respiratory secretions

    * 1 failed spontaneous breathing trial
    * 1 comorbidity
    * 7 days under mechanical ventilation

Exclusion Criteria:

* \<18 years
* thacheotomized patients
* recent facial or cervical trauma/surgery
* active gastro-intestinal bleeding
* lack of cooperation and patients with any failed spontaneous breathing trial because of hypercapnia development.
C: 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.
D: Inclusion Criteria:

* Duration of mechanical ventilation prior to extubation at least 24h
* Planned extubation decided by the physician in charge of the patient after success of a weaning trial
* Patients at high risk of reintubation according to the following criteria: patients older than 65 years, or those having any underlying chronic cardiac or lung disease.

Exclusion Criteria:

* Patient admitted for traumatic brain injury
* Periphal neuromuscular disease as reason for intubation
* Usual lon-term treatment with NIV for chronic desease
* Usual lon-term treatment with CPAP for obstructive apneas syndrome
* Contraindication to NIV
* Unplanned extubation
* Do-not-reintubated order at time of extubation
* Terminal extubation for end of life
* People under legal protection
* Opposition to participate

Answer: D