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Simultaneous reduction of flow and fraction of inspired oxygen (FiO2) versus reduction of flow first or FiO2 first in patients ready to be weaned from high-flow nasal cannula oxygen therapy: study protocol for a randomized controlled trial (SLOWH trial)

DC Field Value Language
dc.contributor.authorKim, Min Chul-
dc.contributor.authorPark, Jong Sun-
dc.contributor.authorLee, Yeon Joo-
dc.contributor.authorCho, Young-Jae-
dc.contributor.authorYoon, Ho Il-
dc.contributor.authorLee, Choon-Taek-
dc.contributor.authorLee, Jae Ho-
dc.contributor.authorKim, Eun Sun-
dc.date.accessioned2020-04-03T07:30:13Z-
dc.date.available2020-04-03T16:30:58Z-
dc.date.issued2020-01-14-
dc.identifier.citationTrials, 21(1):81ko_KR
dc.identifier.issn1745-6215-
dc.identifier.uri10.1186/s13063-019-4019-7-
dc.identifier.urihttps://hdl.handle.net/10371/164923-
dc.description.abstractBackground
High-flow nasal cannula (HFNC) oxygen therapy has been widely used in critically ill patients. Despite the effectiveness of HFNC as a treatment, optimal methods to withdraw HFNC after recovery from preexisting conditions have not been investigated to date. In this study, we will evaluate the safety and efficacy of simultaneous reduction of flow and fraction of inspired oxygen (FiO2) compared with sequential reduction of either flow first or FiO2 reduction first in patients with HFNC.

Methods/design
This is a prospective, investigator-initiated, randomized controlled trial with three experimental intervention groups. A total of 100 adult patients receiving HFNC and satisfying weaning criteria will be enrolled and randomly assigned to one of the following groups: flow reduction (FR) first, FiO2 reduction (OR) first, or simultaneous reduction (SR). In the FR group, flow will be reduced first by 10 L/min/h. When it reaches 20 L/min, FiO2 will then be reduced by 0.1 /h until it reaches 0.3. In the OR group, the FiO2 will be gradually reduced first by 0.1 /h until it reaches 0.3, then flow will be reduced by 10 L/min until it reaches 20 L/min. Finally, in the SR group, both the flow and FiO2 will be gradually reduced simultaneously by 10 L/min and 0.1/h, respectively. Weaning will proceed only when patients satisfy the weaning criteria at every weaning point. When the HFNC weaning-off targets are reached (20 L/min and 0.3 for flow and FiO2, respectively), the patient will be transferred to conventional oxygen therapy (mainly low-flow nasal prongs). The primary outcome is the time to successful weaning from HFNC for 24 h. Secondary outcomes will include the success or failure rate in weaning off HFNC and changes in arterial blood gas analyses, intolerance rate, length of hospital stay, and in-hospital mortality.

Discussion
This study will be the first clinical trial to investigate the safety and efficacy of three different methods of weaning in adult patients receiving HFNC. Once this study is completed, we expect to be able to suggest the better strategy for withdrawal of HFNC based on the results.

Trial registration
ClinicalTrials.gov, NCT03845244. Registered on 19 February 2019.
ko_KR
dc.description.sponsorshipThe trial is supported by grant number 02–2018-025 from the Seoul National University Bundang Hospital Research fund. The sponsor of this study had no role in the study design, data collection, data review, data analysis, or report writing.ko_KR
dc.language.isoenko_KR
dc.publisherBMCko_KR
dc.subjectAdult-
dc.subjectHigh-flow nasal cannula-
dc.subjectProtocol-
dc.subjectWeaning-
dc.titleSimultaneous reduction of flow and fraction of inspired oxygen (FiO2) versus reduction of flow first or FiO2 first in patients ready to be weaned from high-flow nasal cannula oxygen therapy: study protocol for a randomized controlled trial (SLOWH trial)ko_KR
dc.typeArticleko_KR
dc.contributor.AlternativeAuthor김민철-
dc.contributor.AlternativeAuthor박종선-
dc.contributor.AlternativeAuthor이연주-
dc.contributor.AlternativeAuthor조영재-
dc.contributor.AlternativeAuthor윤호일-
dc.contributor.AlternativeAuthor이춘택-
dc.contributor.AlternativeAuthor이재호-
dc.contributor.AlternativeAuthor김은선-
dc.citation.journaltitleTrialsko_KR
dc.language.rfc3066en-
dc.rights.holderThe Author(s).-
dc.date.updated2020-01-19T04:33:03Z-
dc.citation.number1ko_KR
dc.citation.startpage81ko_KR
dc.citation.volume21ko_KR
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