Which Place for High Flow Oxygen in ICU ?

Study Overview
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Brief Summary
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Patients with respiratory failure often need oxygen and/or ventilatory support. Patients who need only oxygen support, usually received low flow oxygen (< 15 Liters / min), as well as in respiratory weaning. Now new devices can be used. They provide high flow oxygen with different benefits. This high flow devices provide exact fraction of inspired oxygen (FiO2), allows a positive end expiratory pressure and supplies a wash out flow. The hypothesis of this study is that the high flow oxygen enable more efficient oxygen administration than conventional oxygen. In addition, it would improve the effectiveness of the ventilation of the patient, through flushing the dead space.

Detailed Description
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The investigators hypothesized that when using high flow oxygen therapy, respiratory failure is relieved, as well as ventilation failure, so accessories are less stressed muscles, and this can be demonstrated by the electromyography (EMG) of sterno-mastoid..

Official Title
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Which Place for High Flow Oxygen in Intensive Care Unit ?

Conditions
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Hypoxemia

Intervention / Treatment
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* Device: Optiflow


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with respiratory failure. Spontaneously breathing patient requiring administration at least 40% oxygen, or, Patient under mechanical ventilation, during respiratory weaning. Exclusion Criteria: Facial trauma, active hemoptysis, pneumothorax, thoraco-abdominal surgery or upcoming intubation for spontaneously breathing patients. Neuromuscular disease, altered consciousness or agitation for patients under mechanical ventilation.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: High Flow Oxygen<br>Patients receiving oxygen via high flow oxygen therapy (Optiflow) | Device: Optiflow<br>* patients receive oxygen via high flow oxygen therapy during 20 minutes<br>|
| No Intervention: Conventionnal<br>patients receiving oxygen via conventional way (low flow) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Oxygenation criteria | Arterial oxygen partial pressure (PO2), oxygen saturation by pulse oximetry (SpO2), arterial PO2/FiO2, positive end expiratory pressure (PEEP) | 20 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Ventilation criteria | respiratory rate (RR), arterial partial CO2 pressure (PCO2), pH, sterno-mastoid EMG | 20 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hypoxemia, high flow oxygen therapy, respiratory failure