protocolSection identificationModule nctId: NCT06301035, orgStudyIdInfo id: 2024-01-012, briefTitle: Asymmetric High-flow Nasal Cannula (HFNC) vs Standard HFNC for Post Extubation High-risk Group, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2024-03-18, primaryCompletionDateStruct date: 2024-10-31, completionDateStruct date: 2024-12-31, studyFirstPostDateStruct date: 2024-03-08, lastUpdatePostDateStruct date: 2024-03-08, sponsorCollaboratorsModule leadSponsor name: Samsung Medical Center, class: OTHER, collaborators name: Fisher and Paykel Healthcare, descriptionModule briefSummary: Background The exacerbation of respiratory failure that occurs after endotracheal intubation often occurs in patients who have received mechanical ventilation therapy, and when it occurs, it emerges as an important issue to consider reintubation of endotracheal intubation. High-flow nasal cannula (HFNC) through nasal cannula is known to produce positive airway pressure and deliver a certain amount of oxygen, and recently reported clinical studies have demonstrated the effect of lowering the risk of reintubation after endotracheal intubation, which is recommended for use in recent clinical practice guidelines. However, in patients at high risk of intubation failure, the combination of high-flow oxygen therapy and non-invasive positive-pressure ventilation therapy rather than the application of high-flow oxygen therapy alone through nasal cannula is helpful in reducing the rate of reintubation of endotracheal intubation. However, an alternative to non-invasive positive-pressure ventilation therapy is needed as there is a possibility of complications such as aspiration pneumonia, maladaptation of the application device (mask), and discomfort, making it difficult to apply it in the field.Recently, it has been reported that high flow oxygen therapy through an asymmetric nasal cannula forms sufficient positive pressure in terms of respiratory dynamics, which makes the patient feel comfortable and reduces work of breath. However, no clinical studies have yet compared physiological effects using this method in patients at high risk of extubation failure.Goal The investigators would like to compare the physiological effects of high flow oxygen therapy through 'asymmetric nasal cannula' with high flow oxygen therapy through 'standard nasal cannula' in patients identified as high-risk groups for valvular failure.Hypothesis 'Asymmetric nasal cannula' reduces work of breath compared to 'standard nasal cannula' in high-risk patients with valvular failure., conditionsModule conditions: Acute Respiratory Failure, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: RANDOMIZED, interventionModel: PARALLEL, primaryPurpose: TREATMENT, maskingInfo masking: SINGLE, whoMasked: OUTCOMES_ASSESSOR, enrollmentInfo count: 30, type: ESTIMATED, armsInterventionsModule interventions name: Asymmetric High flow nasal cannula, interventions name: Standard(symmetric) High flow nasal cannula, outcomesModule primaryOutcomes measure: Respiratory Rate Oxygenation (ROX) Index, secondaryOutcomes measure: The Lowest value of SpO2 within 24 hours after extubation, secondaryOutcomes measure: PaO2/FiO2, secondaryOutcomes measure: SpO2/FiO2, secondaryOutcomes measure: changes of end-expiratory lung impedance, at each flow rate measured through Electrical Impedance tomography (EIT), secondaryOutcomes measure: Changes in non-homogeneity indicators measured through EIT (changes in Global homeogeneity index), secondaryOutcomes measure: Respiratory rate, secondaryOutcomes measure: work of breath (Modified Borg Scale, MBS), secondaryOutcomes measure: systolic blood pressure, secondaryOutcomes measure: mean arterial pressure, secondaryOutcomes measure: heart rate, secondaryOutcomes measure: Rate of reintubation within 7 days, secondaryOutcomes measure: Length of ICU stay, secondaryOutcomes measure: Length of hospital stay, secondaryOutcomes measure: ICU Mortality, secondaryOutcomes measure: Hospital Mortality, secondaryOutcomes measure: 28 Day Mortality, secondaryOutcomes measure: 90 Day Mortality, eligibilityModule sex: ALL, minimumAge: 19 Years, stdAges: ADULT, stdAges: OLDER_ADULT, contactsLocationsModule locations facility: Samsung Medical Center, city: Seoul, country: Korea, Republic of, contacts name: Hye Rim Chung, role: CONTACT, phone: +82-2-3410-6399, email: hyerim37.jeong@samsung.com, geoPoint lat: 37.566, lon: 126.9784, hasResults: False