Effect of high-flow nasal cannula oxygen versus standard oxygen on mortality in patients with acute hypoxaemic respiratory failure: protocol for a multicentre, randomised controlled trial (SOHO)

BMJ Open. 2024 Oct 23;14(10):e083232. doi: 10.1136/bmjopen-2023-083232.

Abstract

Introduction: First-line oxygenation strategy in patients with acute hypoxaemic respiratory failure consists in standard oxygen or high-flow nasal oxygen therapy. Clinical practice guidelines suggest the use of high-flow nasal oxygen rather than standard oxygen. However, findings remain contradictory with a low level of certainty. We hypothesise that compared with standard oxygen, high-flow nasal oxygen may reduce mortality in patients with acute hypoxaemic respiratory failure.

Method and analysis: The Standard Oxygen versus High-flow nasal Oxygen-trial is an investigator-initiated, multicentre, open-label, randomised controlled trial comparing high-flow nasal oxygen versus standard oxygen in patients admitted to an intensive care unit (ICU) for acute respiratory failure with moderate-to-severe hypoxaemia. 1110 patients will be randomly assigned to one of the two groups with a ratio of 1:1. The primary outcome is the number of patients who died 28 days after randomisation. Secondary outcomes include comfort, dyspnoea and oxygenation 1 hour after treatment initiation, the number of patients intubated at day 28, mortality in ICU, in hospital and until day 90, and complications during ICU stay.

Ethics and dissemination: The study has been approved by the central Ethics Committee 'Sud Méditerranée III' (2020-07-05) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.

Trial registration number: NCT04468126.

Keywords: Adult intensive & critical care; Pulmonary Disease; Respiratory Therapy; Respiratory infections.

Publication types

  • Clinical Trial Protocol
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Cannula*
  • Humans
  • Hypoxia / mortality
  • Hypoxia / therapy
  • Intensive Care Units
  • Multicenter Studies as Topic
  • Oxygen / administration & dosage
  • Oxygen Inhalation Therapy* / methods
  • Randomized Controlled Trials as Topic
  • Respiratory Insufficiency* / mortality
  • Respiratory Insufficiency* / therapy

Substances

  • Oxygen

Associated data

  • ClinicalTrials.gov/NCT04468126