NIV Versus HFO for Acute Exacerbations of Interstitial Lung Diseases

Study Overview
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Brief Summary
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The objectives of this study are to compare the physiological consequences of high-flow oxygen therapy and noninvasive mechanical ventilation on ventilation, respiratory work and hemodynamics during acute respiratory failure in diffuse interstitial pneumonia.

Official Title
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Evaluation of Physiological Effects of Noninvasive Mechanical Ventilation and High-flow Oxygen Therapy for Acute Exacerbations of Interstitial Lung Diseases

Conditions
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Interstitial Lung Disease, Acute Respiratory Failure

Intervention / Treatment
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* Device: Noninvasive mechanical ventilation
* Device: Nasal high-flow oxygen therapy
* Device: Continuous positive airway pressure


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Age > 18 yrs Hospitalization in intensive care unit Acute exacerbation of a previously/presently documented diffuse (fibrotic) interstitial lung disease Dyspnea majoration since at least 1 month Alveolar or ground-glass opacities on CT-scan that are superposed to interstitial lung disease and not explained by left heart failure or volume overload Hypoxemia requiring oxygen flows > 6 L/min Exclusion criteria: Contraindication to noninvasive ventilation or high-flow oxygen therapy Immediate indication to endotracheal intubation or hemodynamic assistance Body mass index > 40 Presence of a pacemaker or an implantable defibrillator Presence of cutaneous lesions where Pulmovista® belt should be placed Moribund patient Pregnant or breastfeeding women or women of childbearing age without an effective method of contraception Protected adult patient (tutorship or curatorship) Patient deprived of liberty by court or administrative decision No possibility to install nasogastric tube Endotracheal or tracheostomy tube requirement during the study Hemodynamic assistance requirement during the study

Ages Eligible for Study
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Minimum Age: 18 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: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: NIV + CPAP + HFO<br>The patient will be placed under noninvasive mechanical ventilation during 30 min, then continuous positive airway pressure during 30 min and then nasal high-flow oxygen during 30 min. Each period will be separated by a washout period of maximum 30 min under oxygen with a non-rebreathing mask. | Device: Noninvasive mechanical ventilation<br>* Noninvasive mechanical ventilation is a respiratory technique which allows the administration of positive inspiratory and expiratory airway pressures in order to ventilate the lungs.<br>Device: Nasal high-flow oxygen therapy<br>* Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen.<br>Device: Continuous positive airway pressure<br>* Continuous positive airway pressure is a respiratory technique which allows to maintain a constant positive airway pressure during inspiration and expiration.<br>|
| Experimental: NIV + HFO + CPAP<br>The patient will be placed under noninvasive mechanical ventilation during 30 min, then nasal high-flow oxygen during 30 min and then continuous positive airway pressure during 30 min. Each period will be separated by a washout period of maximum 30 min under oxygen with a non-rebreathing mask. | Device: Noninvasive mechanical ventilation<br>* Noninvasive mechanical ventilation is a respiratory technique which allows the administration of positive inspiratory and expiratory airway pressures in order to ventilate the lungs.<br>Device: Nasal high-flow oxygen therapy<br>* Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen.<br>Device: Continuous positive airway pressure<br>* Continuous positive airway pressure is a respiratory technique which allows to maintain a constant positive airway pressure during inspiration and expiration.<br>|
| Experimental: CPAP + NIV + HFO<br>The patient will be placed under continuous positive airway pressure during 30 min, then noninvasive mechanical ventilation during 30 min and then nasal high-flow oxygen during 30 min. Each period will be separated by a washout period of maximum 30 min under oxygen with a non-rebreathing mask. | Device: Noninvasive mechanical ventilation<br>* Noninvasive mechanical ventilation is a respiratory technique which allows the administration of positive inspiratory and expiratory airway pressures in order to ventilate the lungs.<br>Device: Nasal high-flow oxygen therapy<br>* Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen.<br>Device: Continuous positive airway pressure<br>* Continuous positive airway pressure is a respiratory technique which allows to maintain a constant positive airway pressure during inspiration and expiration.<br>|
| Experimental: CPAP + HFO + NIV<br>The patient will be placed under continuous positive airway pressure during 30 min, then nasal high-flow oxygen during 30 min and then noninvasive mechanical ventilation during 30 min. Each period will be separated by a washout period of maximum 30 min under oxygen with a non-rebreathing mask. | Device: Noninvasive mechanical ventilation<br>* Noninvasive mechanical ventilation is a respiratory technique which allows the administration of positive inspiratory and expiratory airway pressures in order to ventilate the lungs.<br>Device: Nasal high-flow oxygen therapy<br>* Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen.<br>Device: Continuous positive airway pressure<br>* Continuous positive airway pressure is a respiratory technique which allows to maintain a constant positive airway pressure during inspiration and expiration.<br>|
| Experimental: HFO + CPAP + NIV<br>The patient will be placed under nasal high-flow oxygen during 30 min, then continuous positive airway pressure during 30 min and then noninvasive mechanical ventilation during 30 min. Each period will be separated by a washout period of maximum 30 min under oxygen with a non-rebreathing mask. | Device: Noninvasive mechanical ventilation<br>* Noninvasive mechanical ventilation is a respiratory technique which allows the administration of positive inspiratory and expiratory airway pressures in order to ventilate the lungs.<br>Device: Nasal high-flow oxygen therapy<br>* Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen.<br>Device: Continuous positive airway pressure<br>* Continuous positive airway pressure is a respiratory technique which allows to maintain a constant positive airway pressure during inspiration and expiration.<br>|
| Experimental: HFO + NIV + CPAP<br>The patient will be placed under nasal high-flow oxygen during 30 min, then noninvasive mechanical ventilation during 30 min and then continuous positive airway pressure during 30 min. Each period will be separated by a washout period of maximum 30 min under oxygen with a non-rebreathing mask. | Device: Noninvasive mechanical ventilation<br>* Noninvasive mechanical ventilation is a respiratory technique which allows the administration of positive inspiratory and expiratory airway pressures in order to ventilate the lungs.<br>Device: Nasal high-flow oxygen therapy<br>* Nasal high-flow is a respiratory technique which allows the administration of warmed and humidified air, associated with oxygen.<br>Device: Continuous positive airway pressure<br>* Continuous positive airway pressure is a respiratory technique which allows to maintain a constant positive airway pressure during inspiration and expiration.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pulmonary compliance | Comparison of global pulmonary compliance (Cglob) under noninvasive ventilation (NIV) and high-flow oxygen therapy (HFO) during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pulmonary compliance | Comparison of global pulmonary compliance (Cglob) under NIV and continuous positive airway pressure (CPAP) during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulmonary compliance | Comparison of global pulmonary compliance (Cglob) under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulmonary compliance | Comparison of global pulmonary compliance (Cglob) under HFO and face mask oxygen therapy (FM) during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulmonary compliance | Comparison of global pulmonary compliance (Cglob) under NIV and face mask oxygen therapy (FM) during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulmonary compliance | Comparison of global pulmonary compliance (Cglob) under CPAP and face mask oxygen therapy (FM) during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Tidal volume | Comparison of Tidal volume under CPAP and face mask oxygen therapy (FM) during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Tidal volume | Comparison of Tidal volume under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Tidal volume | Comparison of Tidal volume under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Tidal volume | Comparison of Tidal volume under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Tidal volume | Comparison of Tidal volume under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Tidal volume | Comparison of Tidal volume under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| end-expiratory lung volume | Comparison of end-expiratory lung volume under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| end-expiratory lung volume | Comparison of end-expiratory lung volume under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| end-expiratory lung volume | Comparison of end-expiratory lung volume under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| end-expiratory lung volume | Comparison of end-expiratory lung volume under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| end-expiratory lung volume | Comparison of end-expiratory lung volume under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| end-expiratory lung volume | Comparison of end-expiratory lung volume under FM and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transpulmonary pressure | Comparison of transpulmonary pressure under FM and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transpulmonary pressure | Comparison of transpulmonary pressure under FM and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transpulmonary pressure | Comparison of transpulmonary pressure under FM and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transpulmonary pressure | Comparison of transpulmonary pressure under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transpulmonary pressure | Comparison of transpulmonary pressure under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transpulmonary pressure | Comparison of transpulmonary pressure under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| driving pressure | Comparison of driving pressure under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| driving pressure | Comparison of driving pressure under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| driving pressure | Comparison of driving pressure under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| driving pressure | Comparison of driving pressure under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| driving pressure | Comparison of driving pressure under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| driving pressure | Comparison of driving pressure under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Global inhomogeneity index | Comparison of Global inhomogeneity index under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Global inhomogeneity index | Comparison of Global inhomogeneity index under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Global inhomogeneity index | Comparison of Global inhomogeneity index under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Global inhomogeneity index | Comparison of Global inhomogeneity index under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Global inhomogeneity index | Comparison of Global inhomogeneity index under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Global inhomogeneity index | Comparison of Global inhomogeneity index under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| respiratory rate | Comparison of respiratory rate under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| respiratory rate | Comparison of respiratory rate under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| respiratory rate | Comparison of respiratory rate under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| respiratory rate | Comparison of respiratory rate under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| respiratory rate | Comparison of respiratory rate under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| respiratory rate | Comparison of respiratory rate under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| inspiratory time | Comparison of inspiratory time under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure swings | Comparison of oesophagal pressure variations between inspiration and expiration under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure swings | Comparison of oesophagal pressure variations between inspiration and expiration under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure swings | Comparison of oesophagal pressure variations between inspiration and expiration under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure swings | Comparison of oesophagal pressure variations between inspiration and expiration under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure swings | Comparison of oesophagal pressure variations between inspiration and expiration under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure swings | Comparison of oesophagal pressure variations between inspiration and expiration under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure variations | Comparison of transdiaphragmatic pressure variations between inspiration and expiration under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure variations | Comparison of transdiaphragmatic pressure variations between inspiration and expiration under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure variations | Comparison of transdiaphragmatic pressure variations between inspiration and expiration under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure variations | Comparison of transdiaphragmatic pressure variations between inspiration and expiration under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure variations | Comparison of transdiaphragmatic pressure variations between inspiration and expiration under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure variations | Comparison of transdiaphragmatic pressure variations between inspiration and expiration under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure time products | Comparison of transdiaphragmatic pressure time products under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure time products | Comparison of transdiaphragmatic pressure time products under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure time products | Comparison of transdiaphragmatic pressure time products under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure time products | Comparison of transdiaphragmatic pressure time products under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure time products | Comparison of transdiaphragmatic pressure time products under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transdiaphragmatic pressure time products | Comparison of transdiaphragmatic pressure time products under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure time products | Comparison of oesophagal pressure time products under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure time products | Comparison of oesophagal pressure time products under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure time products | Comparison of oesophagal pressure time products under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure time products | Comparison of oesophagal pressure time products under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure time products | Comparison of oesophagal pressure time products under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| oesophagal pressure time products | Comparison of oesophagal pressure time products under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| ultrasound diaphragmatic strain. | Comparison of ultrasound diaphragmatic strain under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| diaphragmatic thickening fraction | Comparison of diaphragmatic thickening fraction under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| diaphragmatic thickening fraction | Comparison of diaphragmatic thickening fraction under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| diaphragmatic thickening fraction | Comparison of diaphragmatic thickening fraction under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| diaphragmatic thickening fraction | Comparison of diaphragmatic thickening fraction under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| diaphragmatic thickening fraction | Comparison of diaphragmatic thickening fraction under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| diaphragmatic thickening fraction | Comparison of diaphragmatic thickening fraction under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak inspiratory flow | Comparison of peak inspiratory flow under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak inspiratory flow | Comparison of peak inspiratory flow under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak inspiratory flow | Comparison of peak inspiratory flow under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak inspiratory flow | Comparison of peak inspiratory flow under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak inspiratory flow | Comparison of peak inspiratory flow under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak inspiratory flow | Comparison of peak inspiratory flow under FM and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak expiratory flow | Comparison of peak expiratory flow under FM and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak expiratory flow | Comparison of peak expiratory flow under FM and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak expiratory flow | Comparison of peak expiratory flow under FM and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak expiratory flow | Comparison of peak expiratory flow under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak expiratory flow | Comparison of peak expiratory flow under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| peak expiratory flow | Comparison of peak expiratory flow under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Systolic arterial pressures | Comparison of Systolic arterial pressures under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Systolic arterial pressures | Comparison of Systolic arterial pressures under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Systolic arterial pressures | Comparison of Systolic arterial pressures under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Systolic arterial pressures | Comparison of Systolic arterial pressures under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Systolic arterial pressures | Comparison of Systolic arterial pressures under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Systolic arterial pressures | Comparison of Systolic arterial pressures under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Diastolic arterial pressures | Comparison of Diastolic arterial pressures under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Diastolic arterial pressures | Comparison of Diastolic arterial pressures under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Diastolic arterial pressures | Comparison of Diastolic arterial pressures under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Diastolic arterial pressures | Comparison of Diastolic arterial pressures under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Diastolic arterial pressures | Comparison of Diastolic arterial pressures under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Diastolic arterial pressures | Comparison of Diastolic arterial pressures under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Mean arterial pressure | Comparison of Mean arterial pressures under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Mean arterial pressure | Comparison of Mean arterial pressures under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Mean arterial pressure | Comparison of Mean arterial pressures under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Mean arterial pressure | Comparison of Mean arterial pressures under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Mean arterial pressure | Comparison of Mean arterial pressures under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Mean arterial pressure | Comparison of Mean arterial pressures under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| systolic pulmonary arterial pressure | Comparison of systolic pulmonary arterial pressure under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| systolic pulmonary arterial pressure | Comparison of systolic pulmonary arterial pressure under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| systolic pulmonary arterial pressure | Comparison of systolic pulmonary arterial pressure under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| systolic pulmonary arterial pressure | Comparison of systolic pulmonary arterial pressure under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| systolic pulmonary arterial pressure | Comparison of systolic pulmonary arterial pressure under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| systolic pulmonary arterial pressure | Comparison of systolic pulmonary arterial pressure under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| tricuspid annular plane systolic excursion | Comparison of tricuspid annular plane systolic excursion under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| tricuspid annular plane systolic excursion | Comparison of tricuspid annular plane systolic excursion under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| tricuspid annular plane systolic excursion | Comparison of tricuspid annular plane systolic excursion under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| tricuspid annular plane systolic excursion | Comparison of tricuspid annular plane systolic excursion under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| tricuspid annular plane systolic excursion | Comparison of tricuspid annular plane systolic excursion under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| tricuspid annular plane systolic excursion | Comparison of tricuspid annular plane systolic excursion under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right ventricular strain | Comparison of right ventricular strain under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right ventricular strain | Comparison of right ventricular strain under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right ventricular strain | Comparison of right ventricular strain under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right ventricular strain | Comparison of right ventricular strain under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right ventricular strain | Comparison of right ventricular strain under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right ventricular strain | Comparison of right ventricular strain under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| left ventricular ejection fraction | Comparison of left ventricular ejection fraction under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| left ventricular ejection fraction | Comparison of left ventricular ejection fraction under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| left ventricular ejection fraction | Comparison of left ventricular ejection fraction under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| left ventricular ejection fraction | Comparison of left ventricular ejection fraction under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| left ventricular ejection fraction | Comparison of left ventricular ejection fraction under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| left ventricular ejection fraction | Comparison of left ventricular ejection fraction under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| E/E' ratio | Comparison of E/E' ratio under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| E/E' ratio | Comparison of E/E' ratio under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| E/E' ratio | Comparison of E/E' ratio under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| E/E' ratio | Comparison of E/E' ratio under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| E/E' ratio | Comparison of E/E' ratio under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| E/E' ratio | Comparison of E/E' ratio under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right auricular pressure | Comparison of right auricular pressure under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right auricular pressure | Comparison of right auricular pressure under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right auricular pressure | Comparison of right auricular pressure under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right auricular pressure | Comparison of right auricular pressure under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right auricular pressure | Comparison of right auricular pressure under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| right auricular pressure | Comparison of right auricular pressure under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| cardiac output | Comparison of cardiac output under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| cardiac output | Comparison of cardiac output under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| cardiac output | Comparison of cardiac output under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| cardiac output | Comparison of cardiac output under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| cardiac output | Comparison of cardiac output under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| cardiac output | Comparison of cardiac output under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| heart rate | Comparison of heart rate under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| heart rate | Comparison of heart rate under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| heart rate | Comparison of heart rate under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| heart rate | Comparison of heart rate under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| heart rate | Comparison of heart rate under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| heart rate | Comparison of heart rate under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulsed oxymetry | Comparison of pulsed oxymetry under NIV and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulsed oxymetry | Comparison of pulsed oxymetry under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulsed oxymetry | Comparison of pulsed oxymetry under NIV and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulsed oxymetry | Comparison of pulsed oxymetry under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulsed oxymetry | Comparison of pulsed oxymetry under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Pulsed oxymetry | Comparison of pulsed oxymetry under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transcutaneous carbon dioxide pressure | Comparison of transcutaneous carbon dioxide pressure under CPAP and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transcutaneous carbon dioxide pressure | Comparison of transcutaneous carbon dioxide pressure under CPAP and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transcutaneous carbon dioxide pressure | Comparison of transcutaneous carbon dioxide pressure under CPAP and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transcutaneous carbon dioxide pressure | Comparison of transcutaneous carbon dioxide pressure under FM and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transcutaneous carbon dioxide pressure | Comparison of transcutaneous carbon dioxide pressure under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| transcutaneous carbon dioxide pressure | Comparison of transcutaneous carbon dioxide pressure under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Dyspnea | Comparison of Borg's scale (from 0 to 10, 10 is maximal dyspnea) under HFO and FM during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Dyspnea | Comparison of Borg's scale (from 0 to 10, 10 is maximal dyspnea) under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Dyspnea | Comparison of Borg's scale (from 0 to 10, 10 is maximal dyspnea) under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Dyspnea | Comparison of Borg's scale (from 0 to 10, 10 is maximal dyspnea) under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Dyspnea | Comparison of Borg's scale (from 0 to 10, 10 is maximal dyspnea) under FM and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Dyspnea | Comparison of Borg's scale (from 0 to 10, 10 is maximal dyspnea) under FM and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Comparison of Comfort | Visual comfort scale (from 0 to 10, 10 is maximal confort) under FM and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Comparison of Comfort | Visual comfort scale (from 0 to 10, 10 is maximal confort) under FM and HFO during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Comparison of Comfort | Visual comfort scale (from 0 to 10, 10 is maximal confort) under FM and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Comparison of Comfort | Visual comfort scale (from 0 to 10, 10 is maximal confort) under NIV and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Comparison of Comfort | Visual comfort scale (from 0 to 10, 10 is maximal confort) under HFO and CPAP during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 
| Comparison of Comfort | Visual comfort scale (from 0 to 10, 10 is maximal confort) under HFO and NIV during acute respiratory failure in diffuse interstitial pneumonia. | During the intervention, after an exposure of 30 minutes to the oxygen therapy device | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diaphragm, Noninvasive mechanical ventilation, Nasal high-flow oxygen therapy, Respiratory work, Hemodynamics