Clinical Research Directory

Patients with acute hypoxemia respiratory failure Inclusion Criteria: * Age \> 18 years old * Acute respiratory failure within 7 days of hospital admission? * Hypoxemia defined by arterial partial pressure of oxygen (PaO2)/FiO2 \< 300 mmHg or SpO2/FiO2 \< 315 * Already supported with HFNC device Exclusion Criteria: * Respiratory acidosis: pH \< 7.30 and PaCO2 \> 45 mmHg * Hemodynamic instability requiring vasopressor initiation * Diminished level of consciousness or uncooperative * Active hemoptysis or pneumothorax requiring a chest tube * Chronic severe neuromuscular disease * Pregnancy Patients with acute hypercapnic COPD Inclusion criteria * Age \> 40 years old * Diagnosed COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (postbronchodilator forced expiratory volume at 1 second (FEV1)/forced vital capacity (FVC) \< 70%) * Exacerbation requiring hospitalization; at least 2 of the following criteria 1. Respiratory rate \> 24/min 2. Use of respiratory accessory muscles or paradoxical motion of the abdomen 3. Acute respiratory acidosis with arterial or venous pH \< 7.35 and/or PaCO2 \> 45 mmHg Exclusion criteria * pH \< 7.25 * Hemodynamic instability requiring vasopressor initiation * Persistent hypoxemia despite supplemental oxygen therapy * Diminished level of consciousness or uncooperative * Active hemoptysis or pneumothorax requiring a chest tube * Associated severe chronic neuromuscular disease * Pregnancy