Helmet vs. mask vs. oxygen: which keeps patients off breathing tubes?
NCT ID NCT05089695
First seen Jun 27, 2026 · Last updated Jun 27, 2026
Summary
This study tests three ways to help patients with severe low oxygen levels breathe better without needing a breathing tube. About 1,200 adults will be randomly assigned to receive either a helmet mask that pushes air, a helmet mask that keeps airways open, or high-flow oxygen through the nose. The goal is to see which method reduces the need for a breathing tube and helps patients recover faster.
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Study facts
What this study's own registry entry says, in plain language.
- Phase
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Not a phased trial
Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.
- Participants
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About 1,200 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Mar 2022
- Expected to finish
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Jun 2026
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
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Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Acute symptoms of respiratory failure PaO2/FiO2 ratio ≤ 200; PaCO2≤45mmHg; Absence of history of chronic respiratory failure or moderate to severe cardiac insufficiency (NYHA\>2 or left ventricular ejection fraction\<50%); Informed consent Patients that have already received NIV, CPAP continuously for more than 24 hours before the screening visit will be excluded. Other Exclusion Criteria: * Pregnancy; * Exacerbation of asthma or chronic obstructive pulmonary disease; * Hypercapnia (PaCO2\>45 mmHg) with or without respiratory acidosis; * More than 2 organ failures, including the lung. * Documented pneumothorax; * Clinical diagnosis of Cardiogenic pulmonary edema; * Haemodynamic instability (Systolic blood pressure\<90 mmHg or mean arterial pressure\<65mmHg) and/or lactic acidosis (lactate\>5 mmol/L) and/or clinically diagnosed Shock requiring administration of vasoactive agents (norepinephrine\>0.1 mcg/Kg/min); * Metabolic Acidosis (pH \<7.30 with normal- or hypo-carbia); * Chronic kidney failure requiring dialysis before ICU admission; * Chronic hypoxemic respiratory failure requiring long-term oxygen therapy; * Altered neurological status that requires immediate intubation and/or making the patient uncooperative; * Urgent need for endotracheal intubation, according to the decision of the attending physician; * Do not intubate order; * Decision of withdrawal of life-sustaining therapy; * Thoracic or abdominal surgery in the previous 7 days; * Any condition that makes the patient very likely to require endotracheal intubation due to a reason different from respiratory failure; * Recent head surgery or anatomy that prevent the application of helmet or HFNC to patient's face.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
1 site. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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Gemelli
RECRUITINGRome, Italy
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