Comparison of Physiological Effects of Two High-Flow Tracheal Oxygen Versus T-Piece During Spontaneous Breathing Trials
Comparison of Physiological Effects of Two Types of High-Flow Tracheal Oxygen Versus T-Piece During Spontaneous Breathing Trials in Mechanically Ventilated Patients
Jian-Xin Zhou
20 participants
Mar 1, 2025
INTERVENTIONAL
Conditions
Summary
Spontaneous breathing trials (SBT) are essential for assessing extubation tolerance, yet optimal approaches are debated. High-flow nasal oxygen offers benefits like precise oxygen delivery, flow-related positive end-expiratory pressure generation and improved lung function. While high-flow tracheal oxygen can also be used as an SBT method, it has reduced physiological effects due to bypassing the upper airway with a more open circuit. To enhance this limitation, investigators developed a modified high-flow tracheal oxygen tube with a smaller expiratory end diameter to increase expiratory resistance and airway pressure. This is a prospective randomized crossover study that aims to compare the physiological effects of standard and modified high-flow tracheal oxygen versus T-piece during SBT.
Eligibility
Inclusion Criteria2
- Mechanical ventilation for more than 24 hours
- Considered by the physicians for the readiness to wean and ready for spontaneous breathing trials
Exclusion Criteria9
- Age younger than 18 years old
- Pregnancy
- Hemodynamic instability (mean arterial pressure <60 mmHg, heart rate >140 or <60 bpm)
- Respiratory and oxygenation instability (respiratory rate > 35bpm or oxygen saturation measured by pulse oximetry <90%)
- Neuromuscular diseases or phrenic nerve injury
- Recent trauma or surgery to the trachea, esophagus, neck, chest, or stomach
- Pneumothorax or placement of a chest drainage
- Contraindication to electrical impedance tomography (EIT) (implantable defibrillator)
- Anticipating withdrawal of life support
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Interventions
Modified high-flow tracheal oxygen with a flow rate of 40L/min will be performed.
Standard high-flow tracheal oxygen with a flow rate of 40 L/min will be performed.
T-piece will be performed.
Modified high-flow tracheal oxygen with a flow rate of 60L/min will be performed.
Standard high-flow tracheal oxygen with a flow rate of 60 L/min will be performed.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06816706