According to a German study, nasal high-flow (NHF) therapy might be a valuable addition to the existing oxygen delivery devices, particularly in COPD patients that cannot tolerate a mask .
NHF is a promising novel oxygen delivery device that allows a high flow of a heated and humidified gas mixture, thereby promoting higher and more stable inspiratory oxygen fraction values and generating a positive airway pressure that can reduce the work of breathing and enhance patient comfort and tolerance . Stable COPD patients could benefit from its application through a reduction of anatomical dead space and an improvement in mucociliary clearance in conducting airways.
After the positive effects of a pilot study, Dr Jens Bräunlich (Kliniken Aurich-Emden-Norden, Germany) and his team compared NHF with non-invasive ventilation (NIV) in 102 patients with chronic hypercapnic COPD from 14 sites. The primary endpoint was pCO2 changes from baseline blood gas. In addition, lung function, quality of life, and changes in the 6-minute walk test were assessed as secondary endpoints. Patients were allocated to receive NHF or NIV. After 6 weeks, there was a crossover and patients received the other oxygen delivery device.
During treatment with NHF, pCO2 levels decreased by 4.7% compared with 7.1% during treatment with NIV. However, the difference between both devices of 1.4 mmHg was not statistically significant (P=0.12). Both devices improved lung function and quality of life with no differences between the devices, but only NIV led to an increase in the 6-minute walk test.
Dr Bräunlich concluded that NHF may constitute an alternative to NIV in COPD patients with stable chronic hypercapnia, especially in those rejecting NIV or not tolerating a face mask.
- Bräunlich J. Nasal high-flow versus non-invasive ventilation in patients with chronic hypercapnic COPD. Abstract 4350, ERS International Virtual Congress 2020, 7-9 Sept.
- Ischaki E, et al. Eur Resp Rev 2017;26(145):170028.
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Table of Contents: ERS 2020
Letter from the Editor
ERS 2020 Highlights Podcast
COVID-19 and the Lung
COVID-19 infections: Bronchoscopy provides additional diagnostic certainty
COVID-19 vaccines: An ongoing race
COVID-19: What is the risk of reinfection?
COVID-19 App: The Dutch experience
Secondary pulmonary fibrosis: a possible long-term effect of severe COVID-19
COVID-19 survivors benefit from structured follow-up
Early pulmonary rehabilitation post-COVID-19 aids recovery
Asthma – What's New
Mild asthma: A fundamental change in management
Dupilumab shows long-term efficacy in asthma patients
Severe asthma: Oral corticosteroids maintenance therapy associated with toxicity
First-in-class tyrosine kinase inhibitor shows promise in severe asthma
Predicting individual effectiveness of biologics in severe asthma
IL-5 antagonist showed efficacy in chronic rhinosinusitis with nasal polyps
Treatment according to genotype: The future of asthma therapy?
COPD – The Beat Goes On
The role of chronic symptoms as early biomarkers of COPD development
Urgent call for studies in COPD patients aged 40-60 years
Nasal high-flow therapy: a novel treatment option for hypercapnic COPD patients
Exacerbation history is a reliable predictor of future exacerbations
Singing training effective as physical rehabilitation in COPD
Current prediction tools underestimate exacerbation risk of severe COPD patients
Exercise and Sleep: From Impaired Function to New Therapeutic Strategies
CPAP withdrawal has negative consequences for sleep apnoea patients
Physical activity improves AHI in sleep apnoea patients
The Tobacco Epidemic: From Vaping to Cannabis
Poly-use of nicotine products and cannabis: a deadly combination
E-cigarettes: A source of chronic lung inflammation
Social smoking: Do not underestimate the risks
Chronic Cough – State of the Art
LEAD study shows multiple phenotypes in many chronic cough patients
First-in-class P2X3 receptor antagonist shows promise for chronic cough treatment
Lung Cancer Detection
Lung cancer screening: Most patients not eligible 1-2 years prior to diagnosis
Biomarkers: a novel tool to improve lung nodule classification
Distinct changes in lung microbiome precede clinical diagnosis of lung cancer
Best of Posters
Smartphone-based cough detection helpful in predicting asthma deterioration
Reduced lung function associated with cognitive decline in the elderly
Longer hospital stay and fewer transplants for frail ILD patients
Hotter weather may fuel spike in COPD flare-ups
Predicting community-acquired pneumonia outcomes by microRNA testing
Negative-pressure ventilator shows promise in new study