{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:47:44Z","timestamp":1790938064067,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Sport et Collection"},{"name":"AADAIRC"},{"DOI":"10.13039\/501100004431","name":"Fondation de France","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004431","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,19]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A palliative approach to intensive care unit (ICU) patients with acute respiratory failure and a do-not-intubate order corresponds to a poorly evaluated target for non-invasive oxygenation treatments. Survival alone should not be the only target; it also matters to avoid discomfort and to restore the patient\u2019s quality of life. We aim to conduct a prospective multicentre observational study to analyse clinical practices and their impact on outcomes of palliative high-flow nasal oxygen therapy (HFOT) and non-invasive ventilation (NIV) in ICU patients with do-not-intubate orders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is an investigator-initiated, multicentre prospective observational cohort study comparing the three following strategies of oxygenation: HFOT alone, NIV alternating with HFOT and NIV alternating with standard oxygen in patients admitted in the ICU for acute respiratory failure with a do-not-intubate order. The primary outcome is the hospital survival within 14 days after ICU admission in patients weaned from NIV and HFOT. The sample size was estimated at a minimum of 330 patients divided into three groups according to the oxygenation strategy applied. The analysis takes into account confounding factors by modelling a propensity score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the ethics committee and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\" xlink:href=\"NCT03673631\">NCT03673631<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045659","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T14:19:07Z","timestamp":1613139547000},"page":"e045659","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of high-flow nasal oxygen therapy and non-invasive ventilation in ICU patients with acute respiratory failure and a do-not-intubate orders: a multicentre prospective study OXYPAL"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct03673631","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5989-5409","authenticated-orcid":false,"given":"Ren\u00e9","family":"Robert","sequence":"first","affiliation":[{"name":"M\u00e9decine Intensive R\u00e9animation, Centre Hospitalier Universitaire de Poitiers, Poitiers, France"},{"name":"ALIVE Research Group, CIC 1402 INSERM, University of Poitiers, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Frasca","sequence":"additional","affiliation":[{"name":"Methods in Patient-Centered Outcomes and Health Research, INSERM UMR1246, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Badin","sequence":"additional","affiliation":[{"name":"Service de R\u00e9animation M\u00e9dico-Chirurgicale, Blois, France, Centre Hospitalier de Blois, Blois, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Girault","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Rouen,CHU de Rouen,Service de R\u00e9animation M\u00e9dicale, Rouen University Hospital, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Guitton","sequence":"additional","affiliation":[{"name":"Service de R\u00e9animation M\u00e9dico-Chirurgicale et Unit\u00e9 de Surveillance Continue, Centre Hospitalier Le Mans, Le Mans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Djibre","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Intensive R\u00e9animation, H\u00f4pital Tenon, APHP, Sorbonne Universit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Beuret","sequence":"additional","affiliation":[{"name":"Service de R\u00e9animation et Soins Continus, Centre Hospitalier de Roanne, Roanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Reignier","sequence":"additional","affiliation":[{"name":"Medecine Intensive R\u00e9animation, Universit\u00e9 de Nantes, CHU de Nantes, Nantes, Pays de la Loire, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalila","family":"Benzekri-Llefevre","sequence":"additional","affiliation":[{"name":"Service de R\u00e9animation Polyvalente, Centre Hospitalier R\u00e9gional, Hopital de la Source, Orleans, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suela","family":"Demiri","sequence":"additional","affiliation":[{"name":"Service de Pneumologie, M\u00e9decine intensive \u2013 R\u00e9animation (D\u00e9partement \"R3S\"), AP-HP. 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