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. 2017 May 30;2017(5):CD010172. doi: 10.1002/14651858.CD010172.pub2

Schwabbauer 2014.

Study characteristics
Methods RCT, cross‐over design. Single‐centre study
Participants Total number of randomized participants: 14
Setting: medical ICU; Germany
Inclusion criteria: patients with hypoxic respiratory failure (PaO2 < 55 mmHg under room air)
Exclusion criteria: ventilatory failure, haemodynamic instability, cardiogenic pulmonary oedema, non‐invasive ventilation contraindications, inability to co‐operate
Baseline characteristics (recorded before each cross‐over period)

  • Age, mean (SD): 55.9 (± 20.36) years

  • Gender, M/F: not reported

  • BMI, mean (SD): 26.71 (± 3.99) kg/m2

  • SAPS II, mean (SD): 41.21 (± 11.78)

  • PaCO2, mean (SD): baseline 1: 36 (± 5); baseline 2: 38 (± 5); baseline 3: 37 (± 5)

  • PaO2/FiO2: not reported

  • Respiratory rate, mean (SD): baseline 1: 28 (± 9); baseline 2: 28 (± 9); baseline 3: 26 (± 7) (breaths/min)
Interventions Participants were treated in randomized order for 30 minutes.
Intervention group (HFNC):

  • Details: HFNC, Optiflow system, Fisher & Paykel Healthcare; oxygen flow 55 L/min; FiO2 0.6, using active respiratory gas humidifier


Control group one (standard oxygen therapy):

  • Details: Venturi mask, Oxygen flow 15 L/min; FiO2 0.6


Control group two (NIV):

  • Details: Non‐invasive ventilation, Intensive care ventilators in pressure support mode; PEEP set to 5 cm H2O; pressure support above PEEP adjusted individually to achieve tidal volume of 6 to 8 mL/kg ideal body weight; FiO2 0.6


Each treatment phase was preceded by a 15‐minute baseline phase during which participants received oxygen via a standard nasal prong (oxygen flow 4 to 12 L/min, SaO2 goal ≥ 88%).
Outcomes PaO2, respiratory rate, dyspnoea (Borg scale), discomfort (10‐point scale), PaCO2, heart rate, blood pressure, SpO2, global rating, patient preference
Note: we did not include outcome data in the review because the study authors did not report outcome data from the first study period.
Notes Funding/declarations of interest: Fisher & Paykel Healthcare Ltd provided 2 Optiflow devices at no charge for the study. Investigators received no financial support and manufacturer had no part in study design, conduct, analysis, reporting, or publication.
Study dates: March 2009 to March 2011