Acute Respiratory FailureSOHONCT04468126
Standard Oxygen Versus High Flow Nasal Cannula Oxygen Therapy in Patients With Acute Hypoxemic Respiratory Failure
A study testing Standard oxygen and High-flow nasal oxygen therapy in people with Acute Respiratory Failure and Hypoxemic Respiratory Failure, run by Poitiers University Hospital at 1 site in France.
Trial summary
First-line therapy of patients with acute respiratory failure consists in oxygen delivery through standard oxygen, high-flow nasal oxygen therapy through cannula or non-invasive ventilation. Non-invasive ventilation in acute hypoxemic respiratory failure is not recommended. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Respiratory Failure, Hypoxemic Respiratory Failure
- What is being tested?
- Standard oxygen and High-flow nasal oxygen therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,504 participants
- Where
- 1 siteFrance
- Study dates
- 19 Jan 2021to 31 Dec 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- All consecutive patients older than 18 years with an acute hypoxemic respiratory failure will be enrolled if they meet all the following criteria:
- Respiratory rate >25 breaths/min whatever the oxygen support
- Pulmonary infiltrate,
- PaO2/FiO2 ≤200 mmHg
- Informed consent from the patient or relatives.
Who cannot join
- PaCO2 > 45 mm Hg
- Need for emergent intubation: pulse oximetry < 90% with maximum oxygen support, respiratory arrest, cardiac arrest, or Glasgow coma scale below 8 points
- Hemodynamic instability defined by signs of hypoperfusion or use of vasopressors > 0.3 µg/kg/min
- Glasgow coma scale equal to or below 12 points
- Exacerbation of chronic lung disease including chronic obstructive pulmonary disease (grade 3 or 4 of Gold classification), or another chronic lung disease with long term oxygen or ventilatory support
- Cardiogenic pulmonary edema as main reason for acute respiratory failure
Show all 13Show fewer
- Coronavirus SARS-2 infection as reason for acute respiratory failure (the SOHO-COVID study has been completed)
- Post-extubation respiratory failure within 7 days after extubation,
- Post-operative patients within 7 days after abdominal or cardiothoracic surgery,
- Do not intubate order;
- Already included in the study, refusal to participate or participation in another interventional study with the same primary outcome.
- Patients without any healthcare insurance scheme or not benefiting from it through a third party,
- Persons under law protection, namely minors, pregnant or breastfeeding women, persons deprived of their liberty by a judicial or administrative decision.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Impact on Mortality of an Oxygenation Strategy Including Standard Oxygen Versus High Flow Nasal Cannula Oxygen Therapy in Patients With Acute Hypoxemic Respiratory Failure: a Prospective, Randomized Controlled Trial.
First-line therapy of patients with acute respiratory failure consists in oxygen delivery through standard oxygen, high-flow nasal oxygen therapy through cannula or non-invasive ventilation. Non-invasive ventilation in acute hypoxemic respiratory failure is not recommended. In a large randomized controlled study, high-flow nasal oxygen has been described as superior to non-invasive ventilation and standard oxygen in terms of mortality but not of intubation. Paradoxically in immunocompromised patients, high-flow nasal oxygen has not been shown to be superior to standard oxygen. To improve the level of evidence of daily clinical practice, we propose comparing high-flow nasal oxygen versus standard oxygen, in terms of mortality in all patients with acute hypoxemic respiratory failure
- Being tested
- Standard oxygen, High-flow nasal oxygen therapy
- Keywords
- acute hypoxemic respiratory failure, de novo respiratory failure, high-flow nasal oxygen, standard oxygen
- Medical subject headings
- Respiratory Insufficiency
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standard oxygenOther
Standard low flow oxygen therapy through facemask or non-rebreathing mask at least 10 L/min.
High-flow nasal oxygen therapyOther
Humidified and heated oxygen with a gas flow at least 50 l/min through nasal cannula and inspired fraction of oxygen adjusted in order to maintain a SpO2 between 92 and 96%
| Study group | Role | What they receive |
|---|---|---|
| standard oxygen group | Active comparator | In order to maintain SpO2 between 92 and 96% Receives: Other: Standard oxygen |
| high-flow nasal cannula oxygen group | Experimental | At least 50 L/min adjusted in order to maintain SpO2 between 92 and 96 % Receives: Other: High-flow nasal oxygen therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mortality at 28 days after randomization
Death between randomization and 28 days after randomization
Measured: Day 28
Secondary outcomes (11)
Failure of the oxygenation strategy between randomization and D28
Intubation between randomization and D28
Measured: Day 28
Mortality in ICU, in hospital, and day 90
Death between randomization and end of stay in ICU, hospital. Death between randomization and day 90.
Measured: Day 90
Number of ventilation free days at Day 28
days alive and without intubation between day 1 and day 28
Measured: Day 28
Duration of ICU and hospital stay
ICU and hospital stay between randomisation and end of stay in ICU and hospital
Measured: Day 90
Complications during the ICU stay
Complications during the ICU stay include: septic shock, nosocomial pneumonia, cardiac arrhythmia, and cardiac arrest.
Measured: Day 90
Dyspnea
feeling is evaluated using a 5-point Likert scale, indicating marked improvement (+2), slight improvement (+1), no change (0), slight deterioration (-1) and marked deterioration (-2)
Measured: Hour 1
Comfort
comfort is evaluated using a 100-mm visual-analogue scale, from 0, i.e. "no discomfort", to100, i.e. "maximal imaginable discomfort"
Measured: Hour [1;6]
Level of oxygenation
Oxygenation is assessed by arterial blood gas sample
Measured: Hour [1;6]
Organ Failure during the 48 hours after intubation.
Organ failure is evaluated by the Sepsis-related Organ Failure Assessment (SOFA) score during the 48 hours after intubation.
Measured: Day 28
Duration between the time when prespecified criteria of intubation are met and intubation
interval between the time when prespecified criteria of intubation are met and intubation
Measured: Day 28
Duration between treatment initiation and intubation
Interval between treatment initiation and intubation
Measured: Day 28
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jul 2020
- Study start19 Jan 2021
- Primary completion30 Oct 2024
- Study completion31 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Acute Respiratory FailureStudies of the same condition, open and under way.
- More trials run by Poitiers University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 1,504 participants (actual)
Sponsor and investigators
- Lead sponsor
- Poitiers University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jean-Pierre FRAT, PhD, Principal investigator, CHU Poitiers
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04468126
- Sponsor's protocol ID
- SOHO
- Acronym
- SOHO
- Status last verified
- Jan 2026
- First submitted
- 8 Jul 2020
- Last updated
- 22 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Our institution does not have a data sharing platform.
Publications
Frat JP, Quenot JP, Guitton C, Coudroy R, Gacouin A, Badie J, Demoule A, Contou D, Carteaux G, Ehrmann S, Jarousseau F, Sedillot N, Rigaud JP, Reignier J, Beloncle F, Dureau AF, Ferre A, Daubin C, Bourreau A, Delbove A, Pradel G, Fatah A, Colin G, Deniel G, Lamouret O, La Combe B, Prat G, Galerneau LM, Bourdin G, Julien G, Curtiaud A, Saint-Leger M, Turbil E, Reynaud F, Chamblet L, Ragot S, Thille AW; SOHO Trial Group and the REVA Network. High-Flow or Standard Oxygen in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2026 Jun 4;394(21):2095-2106. doi: 10.1056/NEJMoa2516087. Epub 2026 Mar 17.
PubMed 41841715Frat JP, Coudroy R, Quenot JP, Guitton C, Badie J, Gacouin A, Ehrmann S, Demoule A, Jarousseau F, Carteaux G, Rigaud JP, Reignier J, Sedillot N, Contou D, Beloncle F, Daubin C, Dureau AF, Fatah A, Besse MC, Ferre A, Turbil E, Merdji H, Galerneau LM, Lacombe B, Richard JC, Romen A, Delbove A, Prat G, Lautrette A, Colin G, Soum E, Bourdin G, Hernandez G, Ragot S, Thille AW; REVA network. Effect of high-flow nasal cannula oxygen versus standard oxygen on mortality in patients with acute hypoxaemic respiratory failure: protocol for a multicentre, randomised controlled trial (SOHO). BMJ Open. 2024 Oct 23;14(10):e083232. doi: 10.1136/bmjopen-2023-083232.
PubMed 39448217Frat JP, Quenot JP, Badie J, Coudroy R, Guitton C, Ehrmann S, Gacouin A, Merdji H, Auchabie J, Daubin C, Dureau AF, Thibault L, Sedillot N, Rigaud JP, Demoule A, Fatah A, Terzi N, Simonin M, Danjou W, Carteaux G, Guesdon C, Pradel G, Besse MC, Reignier J, Beloncle F, La Combe B, Prat G, Nay MA, de Keizer J, Ragot S, Thille AW; SOHO-COVID Study Group and the REVA Network. Effect of High-Flow Nasal Cannula Oxygen vs Standard Oxygen Therapy on Mortality in Patients With Respiratory Failure Due to COVID-19: The SOHO-COVID Randomized Clinical Trial. JAMA. 2022 Sep 27;328(12):1212-1222. doi: 10.1001/jama.2022.15613.
PubMed 36166027
Study at a glance
From the registry record, last updated by the sponsor on 22 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact on Mortality of an Oxygenation Strategy Including Standard Oxygen Versus High Flow Nasal Cannula Oxygen Therapy in Patients With Acute Hypoxemic Respiratory Failure: a Prospective, Randomized Controlled Trial.
- ClinicalTrials.gov ID
- NCT04468126
- Acronym / sponsor ID
- SOHO / SOHO
- Keywords
- acute hypoxemic respiratory failure, de novo respiratory failure, high-flow nasal oxygen, standard oxygen
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,504 participants (actual)
- Lead sponsor
- Poitiers University HospitalUniversity, hospital or other
- Study start
- 19 Jan 2021 (actual)
- Primary completion
- 30 Oct 2024 (actual)
- Study completion
- 31 Dec 2024 (actual)
- First posted
- 13 Jul 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
First-line therapy of patients with acute respiratory failure consists in oxygen delivery through standard oxygen, high-flow nasal oxygen therapy through cannula or non-invasive ventilation. Non-invasive ventilation in acute hypoxemic respiratory failure is not recommended. In a large randomized controlled study, high-flow nasal oxygen has been described as superior to non-invasive ventilation and standard oxygen in terms of mortality but not of intubation. Paradoxically in immunocompromised patients, high-flow nasal oxygen has not been shown to be superior to standard oxygen. To improve the level of evidence of daily clinical practice, we propose comparing high-flow nasal oxygen versus standard oxygen, in terms of mortality in all patients with acute hypoxemic respiratory failure
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| standard oxygen group | Active comparator | Other: Standard oxygenIn order to maintain SpO2 between 92 and 96% |
| high-flow nasal cannula oxygen group | Experimental | Other: High-flow nasal oxygen therapyAt least 50 L/min adjusted in order to maintain SpO2 between 92 and 96 % |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- All consecutive patients older than 18 years with an acute hypoxemic respiratory failure will be enrolled if they meet all the following criteria:
- Respiratory rate >25 breaths/min whatever the oxygen support
- Pulmonary infiltrate,
- PaO2/FiO2 ≤200 mmHg
- Informed consent from the patient or relatives.
Key exclusion criteria (13 listed)
- PaCO2 > 45 mm Hg
- Need for emergent intubation: pulse oximetry < 90% with maximum oxygen support, respiratory arrest, cardiac arrest, or Glasgow coma scale below 8 points
- Hemodynamic instability defined by signs of hypoperfusion or use of vasopressors > 0.3 µg/kg/min
- Glasgow coma scale equal to or below 12 points
- Exacerbation of chronic lung disease including chronic obstructive pulmonary disease (grade 3 or 4 of Gold classification), or another chronic lung disease with long term oxygen or ventilatory support
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Standard oxygenStandard low flow oxygen therapy through facemask or non-rebreathing mask at least 10 L/min. | Other | standard oxygen group |
| High-flow nasal oxygen therapyHumidified and heated oxygen with a gas flow at least 50 l/min through nasal cannula and inspired fraction of oxygen adjusted in order to maintain a SpO2 between 92 and 96% | Other | high-flow nasal cannula oxygen group |
Primary outcome
Mortality at 28 days after randomization
Time frame: Day 28
Death between randomization and 28 days after randomization
11 secondary outcomes
Failure of the oxygenation strategy between randomization and D28
Time frame: Day 28
Mortality in ICU, in hospital, and day 90
Time frame: Day 90
Number of ventilation free days at Day 28
Time frame: Day 28
Duration of ICU and hospital stay
Time frame: Day 90
Complications during the ICU stay
Time frame: Day 90
Dyspnea
Time frame: Hour 1
Comfort
Time frame: Hour [1;6]
Level of oxygenation
Time frame: Hour [1;6]
Organ Failure during the 48 hours after intubation.
Time frame: Day 28
Duration between the time when prespecified criteria of intubation are met and intubation
Time frame: Day 28
Duration between treatment initiation and intubation
Time frame: Day 28
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jan 2026.
- Derived from this study: PubMed 41841715Frat JP, Quenot JP, Guitton C, Coudroy R, Gacouin A, Badie J, Demoule A, Contou D, Carteaux G, Ehrmann S, Jarousseau F, Sedillot N, Rigaud JP, Reignier J, Beloncle F, Dureau AF, Ferre A, Daubin C, Bourreau A, Delbove A, Pradel G, Fatah A, Colin G, Deniel G, Lamouret O, La Combe B, Prat G, Galerneau LM, Bourdin G, Julien G, Curtiaud A, Saint-Leger M, Turbil E, Reynaud F, Chamblet L, Ragot S, Thille AW; SOHO Trial Group and the REVA Network. High-Flow or Standard Oxygen in Acute Hypoxemic Respiratory Failure. N Engl J Med. 2026 Jun 4;394(21):2095-2106. doi: 10.1056/NEJMoa2516087. Epub 2026 Mar 17.
- Derived from this study: PubMed 39448217Frat JP, Coudroy R, Quenot JP, Guitton C, Badie J, Gacouin A, Ehrmann S, Demoule A, Jarousseau F, Carteaux G, Rigaud JP, Reignier J, Sedillot N, Contou D, Beloncle F, Daubin C, Dureau AF, Fatah A, Besse MC, Ferre A, Turbil E, Merdji H, Galerneau LM, Lacombe B, Richard JC, Romen A, Delbove A, Prat G, Lautrette A, Colin G, Soum E, Bourdin G, Hernandez G, Ragot S, Thille AW; REVA network. Effect of high-flow nasal cannula oxygen versus standard oxygen on mortality in patients with acute hypoxaemic respiratory failure: protocol for a multicentre, randomised controlled trial (SOHO). BMJ Open. 2024 Oct 23;14(10):e083232. doi: 10.1136/bmjopen-2023-083232.
- Derived from this study: PubMed 36166027Frat JP, Quenot JP, Badie J, Coudroy R, Guitton C, Ehrmann S, Gacouin A, Merdji H, Auchabie J, Daubin C, Dureau AF, Thibault L, Sedillot N, Rigaud JP, Demoule A, Fatah A, Terzi N, Simonin M, Danjou W, Carteaux G, Guesdon C, Pradel G, Besse MC, Reignier J, Beloncle F, La Combe B, Prat G, Nay MA, de Keizer J, Ragot S, Thille AW; SOHO-COVID Study Group and the REVA Network. Effect of High-Flow Nasal Cannula Oxygen vs Standard Oxygen Therapy on Mortality in Patients With Respiratory Failure Due to COVID-19: The SOHO-COVID Randomized Clinical Trial. JAMA. 2022 Sep 27;328(12):1212-1222. doi: 10.1001/jama.2022.15613.
- Individual participant dataSharing planned: No. Our institution does not have a data sharing platform.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jean-Pierre FRAT, PhD principal investigator
CHU Poitiers
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Standard oxygen and High-flow nasal oxygen therapy in people with Acute Respiratory Failure and Hypoxemic Respiratory Failure, run by Poitiers University Hospital at 1 site in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mortality at 28 days after randomization (time frame: Day 28). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04468126, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2026.