Journal Article

Long-term effects of oxygen-enriched high-flow nasal cannula treatment in COPD patients with chronic hypoxemic respiratory failure

Hockey, Hans, Weinreich, Ulla Møller, Storgaard, Line Hust, Laursen, Birgitte Schantz

2018

Overview

This study investigated the long-term effects of humidified high-flow nasal cannula (HFNC) in COPD patients with chronic hypoxemic respiratory failure treated with long-term oxygen therapy (LTOT). A total of 200 patients were randomized into usual care ± HFNC. At inclusion, acute exacerbation of COPD (AECOPD) and hospital admissions 1 year before inclusion, modified Medical Research Council (mMRC) score, St George's Respiratory Questionnaire (SGRQ), forced expiratory volume in 1 second (FEV ), 6-minute walk test (6MWT) and arterial carbon dioxide (PaCO ) were recorded. Patients completed phone interviews at 1, 3 and 9 months assessing mMRC score and AECOPD since the last contact. At on-site visits (6 and 12 months), mMRC, number of AECOPD since last contact and SGRQ were registered and FEV , FEV %, PaCO and, at 12 months, 6MWT were reassessed. Hospital admissions during the study period were obtained from hospital records. Hours of the use of HFNC were retrieved from the high-flow device. The average daily use of HFNC was 6 hours/day. The HFNC group had a lower AECOPD rate (3.12 versus 4.95/patient/year, <0.001). Modeled hospital admission rates were 0.79 versus 1.39/patient/year for 12- versus 1-month use of HFNC, respectively ( <0.001). The HFNC group had improved mMRC scores from 3 months onward ( <0.001) and improved SGRQ at 6 and 12 months ( =0.002, =0.033) and PaCO ( =0.005) and 6MWT ( =0.005) at 12 months. There was no difference in all-cause mortality. HFNC treatment reduced AECOPD, hospital admissions and symptoms in COPD patients with hypoxic failure.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove Medical Press
• Subject: 6-minute walk test / 6MWT / AECOPD / Aged / Analysis / Blood Gas Analysis / Body mass index / Cannula / Care and treatment / Catheterization - adverse effects / Catheterization - instrumentation / Catheterization - mortality / Cause of Death / Chronic Disease / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Clinical Trial Report / COPD / Denmark / Disease Progression / Dyspnea / Equipment Design / exacerbation / Exercise Tolerance / Expected values / Female / Forced Expiratory Volume / Health care / Health Status / HFNC / high flow heated and humidified oxygen / Hospital admission and discharge / Hospitals / Humans / Hypoxia - diagnosis / Hypoxia - mortality / Hypoxia - physiopathology / Hypoxia - therapy / Lung - physiopathology / Male / Medical records / Medical research / Middle Aged / mMRC score / modified Medical Research Council Score / Mortality / Oxygen Inhalation Therapy - adverse effects / Oxygen Inhalation Therapy - instrumentation / Oxygen Inhalation Therapy - mortality / Patient Admission / Patient admissions / Prospective Studies / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - mortality / Pulmonary Disease, Chronic Obstructive - physiopathology / Pulmonary Disease, Chronic Obstructive - therapy / Quality of Life / Respiratory insufficiency / Respiratory Insufficiency - diagnosis / Respiratory Insufficiency - mortality / Respiratory Insufficiency - physiopathology / Respiratory Insufficiency - therapy / Respiratory system agents / Spirometry / Surveys and Questionnaires / Time Factors / Treatment Outcome / Vital Capacity / Walk Test