High-Flow Nasal Cannula Oxygen Therapy in COPD

High-flow nasal cannula oxygen therapy improved both transcutaneous partial pressure of carbon dioxide (PaCO₂) and 6-minute walking distance in patients with chronic obstructive pulmonary disease (COPD), according to the results of a recent meta-analysis published in the Journal of Clinical Nursing.

Researchers performed the meta-analysis by searching the PubMed, Embase, and Cochrane databases for all existing randomized clinical trials of high-flow nasal cannula oxygen therapy in patients with COPD through November 2020. The primary outcomes were the effects of high-flow nasal cannula oxygen therapy on PaCO₂ and partial pressure of oxygen (PaO₂), and the secondary outcomes were transcutaneous PaCO₂ and 6-minute walking distance.

Among the 379 initial search hits, a total of 9 studies (with 680 total patients) were included in the meta-analysis after application of inclusion and exclusion criteria. When study outcomes were assessed, high-flow nasal cannula did not significantly decrease PaCO₂ or increase PaO₂. However, high-flow nasal cannula decreased transcutaneous PaCO₂ and increased 6-minute walking distance. 

The study authors wrote, “This meta-analysis shows that in patients with chronic obstructive pulmonary disease, high-flow nasal cannula improves both transcutaneous partial pressure of carbon dioxide and 6-[minute] walking distance, suggesting the high-flow nasal cannula has benefits in the management of chronic obstructive pulmonary disease.” They added, “Considering that the literature suggests no impact of high-flow nasal cannula on [hospitalization] and mortality, the benefits of high-flow nasal cannula might be limited to the patients who survive the chronic obstructive pulmonary disease events.”

Reference

Duan L, Xie C, Zhao N. Effect of high-flow nasal cannula oxygen therapy in patients with chronic obstructive pulmonary disease: a meta-analysis. J Clin Nurs. Published online July 9, 2021. doi:10.1111/jocn.15957