HFNC Versus NIV in Hypercapneic COPD Patients

October 1, 2026 updated by: Mohammed Shehta

Gas Exchange, Clinical Outcomes, and Tolerability of High-Flow Nasal Cannula Versus Non-Invasive Ventilation in COPD Patients With Mild-to-Moderate Hypercapnic Respiratory Failure

Aim: To compare gas exchange trends, clinical outcomes, and tolerability between HFNC and NIV in COPD patients with mild-to-moderate hypercapnic respiratory failure.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

70

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Mohammed Shehta, associate professor-chest med.
  • Phone Number: 01004344106
  • Email: dr_mshehta@mans.edu.eg

Study Locations

    • Dakahlia Governorate
      • Al Mansurah, Dakahlia Governorate, Egypt, 35516

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

40 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • COPD patients hospitalized with mild-to-moderate hypercapnic respiratory failure, defined as arterial pH [range, e.g., 7.25-7.35] and PaCO2 [threshold, e.g., >45 mmHg and less 60 mmHg].

Exclusion Criteria:

  • patients with altered mental state, confused, severe agitation or not cooperative were excluded. Also, severe acidosis (pH <7.25), hemodynamic instability, facial trauma or surgery, cases with severe nasal deformity, immediate indication for invasive ventilation, patient refusal, cases with respiratory rate more than 35 breaths per minute. Respiratory exhaustion, excess use of respiratory accessory muscles, Patients with breathing disorders during sleep as well as cases of upper airway obstruction and patients with history of chronic home ventilation prior admission were another items for exclusion

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm 1: high flow nasal canula

patients recieve high flow nasal canula oxygen therapy according to study protocol

high flow nasal canula oxygen therapy according to study protocol

Active Comparator: Arm 2: non invasive ventilation (NIV)

patients recieve NIV according to study protocol

non invasive ventilation according to study protocol

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
treatment failure
Time Frame: From initiation of the assigned respiratory support until hospital discharge, assessed throughout the hospitalization (up to 30 days).

treatment failure defined as the need for escalation from assigned respiratory support to a higher level of ventilatory support during hospitalization. In HFNC group, treatment failure is defined as the need for rescue NIV or invasive mechanical ventilation. In the NIV group ,treatment failure is defined as the need of invasive mechanical ventilation.

( number and percentages of patients experiencing treatment failure in each treatment group)

From initiation of the assigned respiratory support until hospital discharge, assessed throughout the hospitalization (up to 30 days).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
serial arterial blood gas parameters at 12, 24 and 48 hours
Time Frame: at 12, 24, 48 hours after start of respiratory support

serial arterial blood gas parameters (pH, PaCO2, HCO3) at 12, 24 and 48 hours;

at 12, 24, 48 hours after start of respiratory support

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 3, 2025

Primary Completion (Estimated)

November 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

September 19, 2026

First Submitted That Met QC Criteria

October 1, 2026

First Posted (Actual)

October 2, 2026

Study Record Updates

Last Update Posted (Actual)

October 2, 2026

Last Update Submitted That Met QC Criteria

October 1, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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