The passage of air through the nasal cavity generates rhythmic oscillations transmitted by the olfactory bulb to the brain, which induces cerebral activation in functional areas and is associated with better cognitive performance compared to oral breathing. Consequently, the abolition of nasal ventilation in patients intubated via the orotracheal route could have deleterious effects on brain activity. Besides the loss of olfaction, the abolition of nasal ventilation could affect brain activity and respiratory control, consequently altering regional pulmonary ventilation.
The hypothesis of the study is that nasal ventilation through the passage of humidified nasal airflow in patients intubated via the orotracheal route would be associated with modulation of cerebral electrical activity and tissue oxygenation and a modification of regional pulmonary ventilation.
Age ≥ 18 years old
Hypoxemic acute respiratory failure
Intubation and mechanical ventilation since less than 4 days
PaO2/FiO2 ratio less than 200
Central nervous system diseases (stroke, MS, epilepsy)
Psychiatric illnesses (psychosis, depression) (indicated on patient's medical record)
Hemodynamic instability (noradrenalin>2mg/h)
Patient on AME