NCT07381686

High-Flow Nasal Cannula Versus Noninvasive Ventilation After Extubation in Patients With COPD and Mild Hypercapnic Respiratory Failure

Active, enrolled NA Last updated 2 February 2026

What this trial tests

NA trial testing Non-Invasive Ventilation (NIV) in COPD in 150 participants. Participants enrolled and being followed up; not accepting new ones.

Timeline

1 January 2026

Primary endpoint
30 October 2026

30 November 2026

Quick facts

Lead sponsor	Assiut University
Phase	NA
Status	Active, enrolled
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	treatment
Enrollment	150
Start date	1 January 2026
Primary completion	30 October 2026
Estimated completion	30 November 2026
Sites	1 location across Egypt

Drugs / interventions tested

• Non-Invasive Ventilation (NIV)
• High-Flow Nasal Cannula (HFNC)

Conditions studied

• COPD — all drugs for COPD →

Sponsor

Assiut University

Who can join

18 and older, any sex, with COPD. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) represent a leading cause of hospital admissions and respiratory intensive care unit (RICU) stays worldwide. After invasive mechanical ventilation, many COPD patients experience difficulty in the weaning process, with a high hazard of extubation failure due to persistent hypercapnia and weakened respiratory muscle function (1). Extubation failure is allied with increased morbidity, prolonged ICU stay, and higher mortality (2). Thus, effective post-extubation respiratory support strategies are central for improving outcomes in this susceptible group.

Conventionally, noninvasive ventilation (NIV) has been the standard of care after extubation in COPD patients with mild to moderate hypercapnic respiratory failure, as it decreases work of breathing, improves gas exchange, and lowers reintubation rates (4). Though, NIV can be poorly tolerated due to mask-related discomfort, skin breakdown, claustrophobia, and patient-ventilator asynchrony (4).These limits often lead to suboptimal adherence and may compromise its efficacy in practice.

High-flow nasal cannula (HFNC) oxygen therapy has arisen as another, offering heated and humidified oxygen at high flows, which provides low-level positive airway pressure, washes out nasopharyngeal dead space, and improves patient comfort (5). Recent trials suggest that HFNC may be non-inferior to NIV in preventing post-extubation respiratory failure in high-risk populations (6). Yet, data specifically addressing COPD patients with mild hypercapnic respiratory failure remain inadequate, and no agreement exists regarding the optimal strategy in this subgroup. Thus, a direct comparative study between HFNC and NIV in this context is reasonable to guide clinical practice (7).

Publications & conference data

No peer-reviewed publications indexed yet for this trial.