Not Yet RecruitingNot Applicable

Protocolized Weaning of High-Flow Nasal Cannula in Adult Patients

United States2,000 participantsStarted 2026-09-01

Plain-language summary

High-flow nasal cannula (HFNC) is a type of oxygen therapy commonly used in adults with breathing problems. While HFNC can help patients avoid breathing tubes and improve oxygen levels, there is no standard method for deciding how and when to reduce and stop this therapy once a patient improves. In many hospitals, these decisions vary from clinician to clinician. This study will compare usual care with a standardized step-by-step plan for reducing HFNC support. Eight hospitals will participate and will switch from usual care to the standardized plan at different time points during the study. The main goal is to determine whether the standardized weaning plan increases the number of patients who can successfully stop HFNC within 5 days. The study will also evaluate how long patients remain on HFNC, whether they need additional breathing support, and how long they stay in the hospital. The results may help develop clearer guidance for safely and efficiently stopping HFNC therapy.

Who can participate

Age range

18 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Adult patients ≥ 18 years * Receiving HFNC for ≥12 hours * Receiving HFNC to treat acute hypoxemic respiratory failure, defined as requirement of FIO2 ≥ 0.5 to maintain SpO2 at 90-97% and Evidence of increased work of breathing at initiation (e.g., tachypnea with respiratory rate \> 20-25/min, or accessory muscle use), including: * Patients using HFNC to avoid intubation * Post-extubated patients who develop acute hypoxemic respiratory failure, regardless of respiratory support device prior to HFNC use. * The bedside clinical team determines that HFNC weaning is clinically appropriate * Demonstrates clinical stability, defined as: * Respiratory rate ≤ 25 breaths per minute without use of accessory respiratory muscles * SpO₂ \> 90% on HFNC * HFNC FiO₂ ≤ 0.80 Exclusion Criteria: * • Planned procedures requiring intubation * Hypercapnia (PaCO2 ≥ 45 mmHg) * Receiving extracorporeal membrane oxygenation (ECMO) * Receiving continuous aerosol therapy via HFNC (e.g., inhaled nitric oxide \[iNO\], epoprostenol, or continuous albuterol) * Receiving chronic home use of HFNC, CPAP, or noninvasive ventilation therapy to treat chronic respiratory failure * Receiving HFNC as preventative post-extubation therapy, defined as HFNC use immediately after extubation for less than 48 hr in the absence of clinical signs of respiratory failure.

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Proportion of patients successfully weaned from HFNC on day 5 of study enrollment

Timeframe: Up to 5 days after study enrollment

Trial details

NCT IDNCT07452406

SponsorRush University Medical Center

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2028-03-31

Contact for this trial

Jie Li, PhD

13125634643 Jie_Li@rush.edu

View on ClinicalTrials.gov More Acute Hypoxemic Respiratory Failure trials