Nasal High-Flow Oxygen Corrects Hypoxemia, Reduces Hypercapnia in COPD

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Nasal high-flow oxygen therapy is a novel, noninvasive alternative to conventional oxygen therapy for COPD.
Nasal high-flow oxygen therapy is a novel, noninvasive alternative to conventional oxygen therapy for COPD.

Short-term use of nasal high-flow oxygen therapy (HFOT) is safe and effective in correcting hypoxemic respiratory failure and reducing hypercapnia in patients with normocapnic and hypercapnic chronic obstructive pulmonary disease (COPD), according to the results of a recent study published in BMC Pulmonary Medicine.  

Long-term oxygen treatment delivered by means of nasal cannula or oxygen mask has demonstrated efficacy in severe lung disease and can be life extending, but this therapy limits patient mobility and quality of life.

HFOT is a novel, noninvasive alternative to conventional oxygen treatment (COT). It involves the transnasal application of a preheated and moistened air-oxygen composition delivered at high flow rates.

 

Helene Vogelsinger, MD, of the Pneumology Department, Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria, and colleagues investigated the use of HFOT in comparison with COT in a single cohort of 77 patients with clinically stable hypoxemic COPD with an indication for long-term oxygen treatment with or without hypercapnia. Patients were successively treated with COT and HFOT for 60 minutes each, including oxygen adaption with a washout period of 30 minutes between therapies.

This study showed that all patients tolerated HFOT well, and partial pressure of carbon dioxide decreased significantly during oxygen adaptation of HFOT. Partial pressure of oxygen increased substantially, as did peripheral capillary oxygen saturation, and alveolar-arterial oxygen gradient decreased with HFOT. Compared with COT, lower levels of oxygen were required to correct hypoxemic respiratory failure and reduce hypercapnia with HFOT. No residual volumes or any alteration of total lung volumes occurred during therapy, nor were there significant differences in diffusing capacity of the lungs for carbon monoxide or in airway resistance levels, indicating that HFOT was safe.

HFOT appears to be superior to COT for delivering effective oxygenation.

Reference

Vogelsinger H, Halank M, Braun S, et al. Efficacy and safety of nasal high-flow oxygen in COPD patients. BMC Pulm Med. 2017;17:143.

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