High-Flow Nasal Oxygen with or without Helmet Non-invasive Ventilation for Oxygenation Support in Acute Respiratory Failure (HONOUR) Pilot RCT

Patients with severe respiratory failure (including due to COVID-19) are at high risk of dying and will often require invasive mechanical ventilation. These patients typically require supplemental oxygen. However, the best way to deliver supplemental oxygen to these patients - in order to reduce their risk of dying or requiring invasive ventilation - is not known. This pilot study will determine if it is feasible to conduct a large definitive randomized controlled trial that directly compares two different approaches to delivering supplemental oxygen, each of which has potential benefits and risks: providing oxygen at very high flow rates using nasal cannulas, or supplementing this approach by also providing oxygen using a specially designed helmet interface connected to a ventilator. The results of this work will directly inform the design of the large trial comparing these two approaches, which in turn should identify the strategy that saves more lives of patients with acute respiratory failure, including those with COVID-19.