High-Flow Nasal Oxygen Therapy for Exacerbation of Chronic Pulmonary Obstructive Disease.

As soon as admission to the intensive care unit, eligible patients who gave consent will be randomized to either HFNO or Noninvasive ventilation therapy for at least the first 24 hours. In the usual care group , Noninvasive ventilation will be applied in alternance with standard nasal oxygen therapy. In the intervention group, HFNO with be applied continuously over the first 24 hours. In both groups, an oxygen saturation, as assessed by finger pulse oximetry, of 88-92% will be targeted. The primary objective will be two-fold: to compare between groups 1) Efficacy, assessed by the arterial pH at 24 hours, and 2) Safety, assessed by the ratio of the arterial partial pressure in oxygen (PaO2) over the inspired oxygen fraction (FiO2) at 24 hours.