Effect of High-Flow Humidified Oxygen on Ventilatory Work During the Spontaneous Breathing Trial (OTRAVAIL)

Inclusion Criteria:

• Adult patient, of legal age
• On invasive mechanical ventilation for more than 48 hours

• With at least one criterion indicating a high risk of extubation failure:

  • Age > 65 years
  • Chronic respiratory disease
  • Chronic cardiac disease

• Capable of undergoing a mechanical ventilation weaning test ("weaning criterion"):

  • Respiratory rate < 35 bpm

  • Adequate oxygenation:

    • SpO₂ ≥ 90% with FiO₂ ≤ 40% and PEEP ≤ 8 cm H₂O
    • Or PaO₂/FiO₂ ≥ 150 with PEEP ≤ 8 cm H₂O
  • Effective cough
  • Patient is alert (RASS score -2 to +1), without sedation
  • Hemodynamically stable or on the minimum effective dose
• Patient has an invasive arterial pressure catheter for arterial blood sampling
• Informed consent signed by a family member
• Patient is enrolled in or eligible for a social security program

Exclusion Criteria:

• Resuscitation-associated neuromyopathy
• History of neuromuscular disease
• Admission for a neurological condition
• Subjects currently excluded from another study,
• Persons referred to in Articles L1121-5 through L1121-8 of the CSP (corresponding to all protected persons: pregnant women, women in labor, breastfeeding mothers, persons deprived of liberty by judicial or administrative decision, persons receiving psychiatric care pursuant to Articles L. 3212-1 and L. 3213-1 who are not covered by the provisions of Article L. 1121-8, persons admitted to a health or social care facility for purposes other than research, minors, and persons subject to a legal protection order or unable to give informed consent).
• Staff members who report to the principal investigator