Weaning Protocol for High-flow Nasal Oxygen Therapy in Intensive Care

Inclusion Criteria:

• Major patient admitted to the intensive care unit or continuous care unit for de novohypoxaemic acute respiratory failure (with a PaO2/FiO2 ratio <300 mmHg)
• Treated with HFNO with a flow rate ≥ 50L/min and inspired oxygen fraction (FiO2) ≥ 0.5, flow rate and FiO2 having to be stable (i.e. not increased) in the 24 hours priorto inclusion
• With a ROX index (SpO2/FiO2/Respiratory Rate) stable or improving in the 6 hours priorto inclusion and greater than 4.88
• Had a blood gas test under HFNO within 24 hours of inclusion
• Participant covered by or entitled to social security
• Informed consent signed by the patient or its relatives if the patient is incapable;this consent must then be confirmed by the patient as soon as possible

Exclusion Criteria:

• Presence of a patient included in the study and not weaned off HFNO in the sectormanaged by the nurse of the patient assessed for eligibility
• Concomitant non-invasive ventilation treatment
• Use of HFNO within 7 days of extubation
• Chronic obstructive pulmonary disease (Gold grade 3 or 4)
• Cardiogenic acute pulmonary oedema as the main cause of acute respiratory failure
• Diffuse interstitial lung disease as a medical history
• Patient with long-term non-invasive ventilation with external positive pressure
• Patient on long-term oxygen therapy at home
• Pregnant women, women in labour and breastfeeding mothers
• Persons deprived of their liberty by a judicial or administrative decision, personshospitalised without consent and persons admitted to a health or social establishmentfor purposes other than research.
• Minor
• Adult subject to a legal protection measure (guardianship, curators, person undercourt protection)
• Patient with a medical decision not to intubate
• Patients already included in the study, neither for the same stay if they were topresent the inclusion criteria again, nor for subsequent stays