Non-Invasive Ventilation Versus High-flow Nasal Oxygen in Intensive Care Units

To be able to join this study, patients must have been on a breathing machine in the ICU for more than 24 hours before their breathing tube was removed. They also need to develop breathing difficulties within the first seven days after the tube is taken out. These breathing problems are clearly defined by breathing faster than 25 breaths per minute or showing signs of working harder to breathe for at least 30 minutes, combined with changes in their blood gas levels that show low oxygen or too much acid in the blood.

However, some conditions would mean a patient cannot join. This includes if they already use NIV at home, if their ICU stay is due to certain muscle or nerve conditions like Guillain-Barré syndrome, or if their breathing problem is mainly caused by a blockage in their upper airway. Patients also can't be in the study if they need the breathing tube put back in urgently (for example, if they have a cardiac arrest), if their consciousness is severely affected, if their breathing tube already came out by accident, or if they have a 'do not reintubate' order in place. The study is for adults over 18 and includes people of all sexes.

This clinical trial is evaluating different breathing support methods for patients in intensive care units. If a patient is eligible and agrees to participate, their breathing will be supported using either high-flow nasal oxygen alone or a combination of non-invasive ventilation (NIV) and high-flow nasal oxygen. The study will closely monitor their breathing, vital signs, and overall condition to see how well each method works. The main focus will be on their health outcomes and survival. The total duration of participation depends on how long the breathing difficulty lasts and the patient's recovery, but the interventions are typically used during the critical period after breathing tube removal in the ICU.