HFTO Via Tracheal Intubation in Neurocritical Patients

Neurocritical patients often require prolonged invasive ventilation due to impaired respiratory drive and airway protection deficits. While early weaning reduces complications and costs, these patients frequently pass spontaneous breathing trials (SBT) yet remain intubated solely for airway protection. Current practice maintains low-level pressure support ventilation (5-8 cmH₂O) to offset endotracheal tube resistance. However, prolonged ventilation increases risks of ventilator-associated pneumonia (VAP) and diaphragm dysfunction. Emerging evidence suggests appropriately sized tubes may not substantially increase work of breathing (WOB). High-flow oxygen therapy (HFOT) delivers heated, humidified oxygen at high flow rates, reducing WOB and improving oxygenation and comfort. While validated for tracheostomized patients, HFOT via tracheal intubation (HFOT-TI) remains unstudied in neurocritical populations during early weaning. This study aims to evaluate the safety and feasibility of HFOT-TI in neurocritical patients who have passed SBT but require ongoing airway protection.

NCT Number	NCT07257016
Lead Sponsor	Capital Medical University
Conditions	High Flow Oxygen Therapy, Neuro ICU
Enrollment	24 participants
Start Date	2025-12-15
Primary Completion	2026-02-27 (estimated)
Study Completion	2026-04-28 (estimated)
Updated on ClinicalTrials.gov	2026-05-04