Physiological Effects of High-Flow Nasal Oxygen Compared With Conventional Oxygen Therapy: A Randomized Trial in Postextubation Patients

December 15, 2025Critical Care MedicineOpen Access

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Key Points

The aim is to compare the physiological effects of high-flow nasal oxygen and conventional oxygen therapy on respiratory effort and ventilation distribution in postextubation patients.
Randomized trial involving adult patients who were invasively ventilated for over 48 hours.
Intervention groups included high-flow nasal oxygen and conventional oxygen therapy for 24 hours postextubation.
Measurements included esophageal pressure and electrical impedance tomography before extubation and at 24 hours.
At 24 hours, the change in esophageal pressure was 1.5 cm H2O in the conventional oxygen therapy group and -1.3 cm H2O in the high-flow nasal oxygen group (p=0.11).
Change in simplified pressure-time product was 66 in the conventional group and 0 in the high-flow nasal oxygen group (p=0.04).
There were no significant differences in EIT-derived ventilation parameters between the groups.

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Randomized trial compares respiratory effort outcomes in high-flow nasal oxygen versus conventional oxygen therapy.

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Janssen et al. (2025) studied this question.

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