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TerminatedNCT06008587PIRAHNAUpdated Nov 24, 2025

Contribution of Nasal High Flow in Pneumology Assessed in Acid-Free Hypercapnic Acute Respiratory Failure

An interventional study of AIRVO3 TM and Standard therapy in Respiratory Insufficiency, sponsored by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer. Terminated at 3 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-11-24.

Sponsored by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer · Not applicable, Interventional, and Treatment

Why this study was terminated
Impossible to achieve inclusion goals, fewer patients in reality than expected
Phase
Not applicable
Study type
Interventional
Enrollment
16
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The hypothesis is that Nasal High Flow therapy for patients with Hypercapnic Acute Respiratory Failure without acidosis, in addition to standard treatment would improve the care.

Read the detailed description

The aim of the PIRAHNA study is to compare patients treated with Nasal High Flow in association with conventional standard treatment versus patients treated only with conventional standard treatment.

Primary objective : To demonstrate the therapeutic superiority of Nasal High Flow in hypercapnic Acute Respiratory Failure without acidosis, in combination with conventional standard treatment

Secondary objectives :

  1. Identify the characteristics (etiologies) of responder patients (defined by a decrease in capnia and a failure to develop acidosis within two weeks of hospitalization)
  2. Identify the etiology (trigger) of the Acute Respiratory Failure of responder patients
  3. Compare the evolution of respiratory rate between the two treatment groups
  4. Compare the evolution of dyspnea between the two treatment groups
  5. Compare the evolution of gas exchanges between the two treatment groups
  6. Compare the length of stay between the two groups
  7. Compare the evolution of patients comfort state in the two treatment groups
02

Conditions studied

  • Respiratory Insufficiency

Keywords

  • Nasal High Flow
  • Acute Respiratory Failure
  • Respiratory non-acidosis
  • Pneumology
  • Hypercapnia
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Major patient ≥ 18 years old
  • Medical diagnosis of Acute Respiratory Failure less than 48 hours
  • With partial pressure of carbon dioxide (PaCO2) > 45 and pH > 7.35 for less than 48 hours, with no indication of Non-Invasive Ventilation (NIV) placement
  • Underlying terrain of known or unknown chronic respiratory pathology (may be unknown at time of diagnosis) Examples : COPD, Bronchiectasis, Pulmonary fibrosis, asthma, sequelae pathologies …
  • All etiologies (infectious, cardiac decompensation, trauma, etc.)
  • Having given informed consent
  • Patient under a social security scheme
  • Possibility to include a patient having already been included in the study but suffering from a new episode of hypercapnic non acidic Acute Respiratory Failure with a free interval of 3 months

Exclusion criteria

Exclusion Criteria:

  • Restrictive chronic neuromuscular or kyphoscoliotic respiratory insufficiencies
  • Drug-induced Acute respiratory failure
  • Pneumothorax (X-ray pulmonary detachment)
  • Oxygen poisoning. In this case, PaCO2 will be asset again later with the purpose to include after oxygenotherapy decrease for a target SpO2 of 92% maximum
  • Severe Acute Respiratory Syndrome (SARS) Coronavirus 2 (COVII) Pneumonia
  • Tracheostomy
  • Prior treatment with chronic or initiated NIV just prior to treatment (e.g. Intensive Care Unit)
  • Respiratory Severity Criteria for Resuscitation Management
  • Agitation or non-cooperation
  • Pregnancy or breastfeeding
  • Person participating in other biomedical research
  • Any other reason that the investigator believes may interfere with the evaluation of the study objectives
  • Person under judicial protection (guardianship, curatorship)
  • Person deprived of liberty by a judicial or administrative decision
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
16 participants (actual)

Study arms

  • Experimental
    Nasal High Flow therapy in association with the standard therapy

    Device: AIRVO3 TM · Other: Standard therapy

  • Active comparator
    Standard therapy alone

    Other: Standard therapy

Interventions

  • DeviceAIRVO3 TM

    A device that provides high flows of heated and humidified respiratory gases to patient who breath spontaneously. Patients will be treated with the device up to 15 days or until the occurrence of respiratory acidosis defined by pH\<7.35, whichever come first.

  • OtherStandard therapy

    Standard therapy depends on the acute respiratory failure etiology. Treatments will be administered at the investigator's discretion in accordance with the standard of care.

05

What researchers measure

Primary outcomes

  1. Failure of the Nasal High Flow

    Failure of the Nasal High Flow is defined by the occurrence of respiratory acidosis (pH\<7.35) within 2 weeks after admission

    Time frame: Up to 2 weeks

Secondary outcomes

  1. Responding patients phenotype

    Phenotype will be characterized by the presence of one or more of the following elements : obesity hypoventilation syndrome, chronic obstructive pulmonary disease (COPD) emphysema, thoracic enlargement, bronchiectasis.

    Time frame: At Day 30 after hospital discharge

  2. Etiology of acute respiratory failure

    The triggers of acute respiratory failure will be assessed : bacterial secondary infection, viral infection, bronchospasm, ...

    Time frame: Up to 2 weeks

  3. Respiratory rate

    Respiratory rate will be recorded from Day 0 to Day 15, or until discharge (if less than 15 days).

    Time frame: Up to 2 weeks

  4. Dyspnea

    Dyspnea will be assessed by the modified Borg scale rating of perceived exertion (RPE) from Day 0 to Day 15. The minimum value of the scale corresponding to no shortness of breath is 0 and the maximum value corresponding to dyspnea is 10. Higher score means a worse outcome.

    Time frame: Up to 2 weeks

  5. pH

    pH will be assessed from Day 0 to Day 15.

    Time frame: Up to 2 weeks

  6. Partial Pressure of Carbon dioxide (PCO2)

    PCO2 will be assessed from Day 0 to Day 15.

    Time frame: Up to 2 weeks

  7. Bicarbonates

    HCO3- will be assessed from Day 0 to Day 15.

    Time frame: Up to 2 weeks

  8. pCO2 normalization time

    Time frame: Up to 2 weeks

  9. ROX index

    ROX index will be performed from Day 0 to Day 15.

    Time frame: Up to 2 weeks

  10. Length of hospital stay

    Duration will be recorded in days medically necessary in the pneumology department

    Time frame: Up to 2 weeks

  11. Comfort Visual Analogic Scale (VAS)

    Patient's comfort will be assessed on a Visual Analogic Scale at Day 0, Day 7 and Day 15 or at hospital discharge. The minimum value of the scale, corresponding to no discomfort is 0 and the maximum value corresponding to the maximum discomfort, is 10. Higher score means a worse outcome.

    Time frame: Up to 2 weeks

06

Study locations

3 sites
  • Centre Hospitalier de Cannes
    Cannes, Alpes Maritime 06400, France
  • Centre Hospitalier Intercommunal de Toulon- La Seyne sur Mer - Hôpital Sainte Musse
    Toulon, Var 83100, France
  • Centre Hospitalier Princesse Grace
    Monaco, 98000, Monaco
07

Registry details

Key details

Study ID
NCT06008587
Lead sponsor
Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
Responsible party
Sponsor
First posted
Aug 23, 2023
Start date
Feb 27, 2024
Primary completion
Sep 24, 2025
Completion
Sep 24, 2025
Last update
Nov 24, 2025

Study contacts

Cécile MAINCENT, MD
study director · Centre Hospitalier Princesse Grace

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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