Chanques 2013.

Study characteristics
Methods	RCT, cross‐over study. Single‐centre study
Participants	Total number of participants: 10 Setting: medical‐surgical ICU; Montpelier, France Inclusion criteria: ≥ 18 years old hospitalized in a medical‐surgical ICU, planned for tracheostomy tube removal which was placed in the ICU for weaning from mechanical ventilation Exclusion criteria: pregnancy, adult under tutelage, contraindications for NIV Baseline characteristics (all patients): Age: 54 to 66 years Respiratory rate, median (IQR): 18 (22 to 20) breaths/min PaCO2: not reported PaO2/FiO2: not reported
Interventions	Flow rates of 15, 30, and 45 litres per minute were tested in a randomized order for each device. High‐flow face mask with a reservoir bag Optiflow high‐flow nasal cannulae Boussignac oxygen therapy system& For each device and flow rate, participants were asked to have their mouth open and mouth closed in a randomized order. Each device was used for 5 minutes, with 15‐minute washout between treatments.
Outcomes	Tracheal pressure, FiO2 delivered, respiratory discomfort, respiratory rate (at end of each treatment period), noise intensity
Notes	Funding sources/declarations of interest: Study authors disclosed funding of €3000 from Fisher & Paykel Healthcare Ltd, France, which was used to acquire technical equipment and clinical research insurance, and to present results at scientific meetings. Study dates: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method of randomization not stated
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment not stated
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Blinding was not possible. Although we expected that this would not influence outcome data, we could not be certain of this.
Blinding of outcome assessors (objective outcomes)	Low risk	Investigators were outcome assessors for objective outcomes, but standardized tools were used for measurement, reducing risk of bias.
Blinding of outcome assessors (subjective measures)	Low risk	Participants were outcome assessors for respiratory and auditory discomfort on a standardized scale. We did not think this would influence the subjective outcome data.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	One participant was excluded owing to major intolerance to the device but possibly should have been regarded as a treatment failure. In such a small study, this is likely to have had an effect. Owing to inability of 4 participants in the Boussignac group to adhere to the protocol, it is likely that data were incomplete; however it was not mentioned how this was handled in the analysis.
Selective reporting (reporting bias)	Unclear risk	ISRCTN15995925. Retrospectively registered in August 2012. Not possible to establish any reporting bias through comparison with the trial register protocol
Other bias	Low risk	We identified no other risks of bias.