支气管纤维镜检查 (FOB) 是一种常规检查，用于治疗：肺癌、阻塞、间质性疾病、异物清除、气道清理和咯血。它会导致急性气道狭窄，导致呼吸和心血管压力。由于患有呼吸衰竭 (RF) 的患者数量不断增加，传统氧疗 (COT) 通常不足以确保准确的氧合并预防需要 FOB 的患者发生 RF。在这种临床情况下，患者可能会接受插管并接受有创机械通气 (IMV) 支持，其具体目的是实现安全的 FOB。然而，这种侵入性策略会增加 IMV 相关并发症的风险。我们的研究是一项计划中的前瞻性多中心三臂随机对照试验 (RCT)。 300名患者的目标数量是根据RF患者的插管风险（0.2-2%）计算的。将根据 Horowitz 指数将患者分配到每个组。在每组中，患者将被随机分配到每组的两种专用呼吸支持方法中的一种，即 COT/高流量鼻插管 (HFNC)、HFNC/无创通气 (NIV) 和 NIV/IMV。在手稿中讨论了呼吸支持领域的当前技术水平。我们强调了医学证据方面的知识差距，我们计划用我们的结果来揭示这些差距。我们的研究结果在临床上至关重要，因为它们解决了当前有关 COT/HFNC/NIV/IMV 的差距。这项研究的预期结果将允许仔细选择呼吸支持方法，以安全地对低氧性 RF 患者进行 FOB。版权所有 © 2023 作者。由 Elsevier B.V. 出版。保留所有权利。

Bronchofiberoscopy (FOB) is a procedure routinely performed for: lung cancer, obstruction, interstitial diseases, foreign bodies' removal, airway clearance, and hemoptysis. It causes acute airway narrowing leading to respiratory and cardiovascular stress. Due to increasing number of ill patients with respiratory failure (RF), conventional oxygen therapy (COT) is frequently insufficient to assure accurate oxygenation and prevent RF in patients requiring FOB. In this clinical scenario, patients may be intubated and supported with invasive mechanical ventilation (IMV) with the specific aim of allowing a safe FOB. However, this invasive strategy is associated with an increased risk of IMV-associated complications.Our study is a planned prospective multicenter three-arm randomized controlled trial (RCT). The target number of 300 patients was calculated based on the intubation risk in RF patients, which is 0.2-2%. The patients will be assigned to each arm based on Horowitz index. In each arm, the patients will be randomly assigned to one out of two dedicated respiratory support methods in each group i.e. COT/high flow nasal cannula (HFNC), HFNC/non-invasive ventilation (NIV) and NIV/IMV. In the manuscript the current state of art in the area of respiratory support is discussed. We have underlined knowledge gaps in medical evidence which we are planning to reveal with our results.The results of our study are clinically crucial, because they address current gaps concerning COT/HFNC/NIV/IMV.The expected findings of this study would allow for careful selection of respiratory support method to safely perform FOB in patients with hypoxemic RF.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.