Home High-Flow Nasal Cannula Oxygen Therapy for Stable Hypercapnic COPD : A Randomized Clinical Trial
Rationale: The long-term effects of using a high-flow nasal cannula for chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease remain unclear. Objectives: To assess whether long-term high-flow nasal cannula use reduces the number of exacerbations and improves other physiological parameters in patients with chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease. Methods: We enrolled 104 participants (aged ⩾40 yr) with daytime hypercapnia (Global Initiative for Chronic Obstructive Lung Disease stages 2-4) receiving long-term oxygen therapy (⩾16 h/d for ⩾1 mo) and randomly assigned them to high-flow nasal cannula/long-term oxygen therapy and long-term oxygen therapy groups. The primary endpoint was the moderate or severe exacerbation rate. We compared changes from baseline in arterial blood gas values, peripheral oxygen saturation, pulmonary function, health-related quality-of-life scores, and the 6-minute-walk test. Measurements and Main Results: High-flow nasal cannula use significantly reduced the rate of moderate/severe exacerbations (unadjusted mean count 1.0 vs. 2.5, a ratio of the adjusted mean count between groups [95% confidence interval] of 2.85 [1.48-5.47]) and prolonged the duration without moderate or severe exacerbations. The median time to first moderate or severe exacerbation in the long-term oxygen therapy group was 25 (14.1-47.4) weeks; this was not reached in the high-flow nasal cannula/long-term oxygen therapy group. High-flow nasal cannula use significantly improved health-related quality of life scores, peripheral oxygen saturation, and specific pulmonary function parameters. No safety concerns were identified. Conclusions: A high-flow nasal cannula is a reasonable therapeutic option for patients with stable hypercapnic chronic obstructive pulmonary disease and a history of exacerbations. Clinical trial registered with www.umin/ac.jp (UMIN000028581) and www.clinicaltrials.gov (NCT03282019).
| Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2022 Dec 1;206(11):1303-1304. - PMID 35853196 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:206 |
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| Enthalten in: |
American journal of respiratory and critical care medicine - 206(2022), 11 vom: 01. Dez., Seite 1326-1335 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nagata, Kazuma [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 02.12.2022 Date Revised 22.02.2023 published: Print ClinicalTrials.gov: NCT03282019 CommentIn: Am J Respir Crit Care Med. 2022 Dec 1;206(11):1303-1304. - PMID 35853196 Citation Status MEDLINE |
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| doi: |
10.1164/rccm.202201-0199OC |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342923714 |
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| 100 | 1 | |a Nagata, Kazuma |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Home High-Flow Nasal Cannula Oxygen Therapy for Stable Hypercapnic COPD |b A Randomized Clinical Trial |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 02.12.2022 | ||
| 500 | |a Date Revised 22.02.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT03282019 | ||
| 500 | |a CommentIn: Am J Respir Crit Care Med. 2022 Dec 1;206(11):1303-1304. - PMID 35853196 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Rationale: The long-term effects of using a high-flow nasal cannula for chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease remain unclear. Objectives: To assess whether long-term high-flow nasal cannula use reduces the number of exacerbations and improves other physiological parameters in patients with chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease. Methods: We enrolled 104 participants (aged ⩾40 yr) with daytime hypercapnia (Global Initiative for Chronic Obstructive Lung Disease stages 2-4) receiving long-term oxygen therapy (⩾16 h/d for ⩾1 mo) and randomly assigned them to high-flow nasal cannula/long-term oxygen therapy and long-term oxygen therapy groups. The primary endpoint was the moderate or severe exacerbation rate. We compared changes from baseline in arterial blood gas values, peripheral oxygen saturation, pulmonary function, health-related quality-of-life scores, and the 6-minute-walk test. Measurements and Main Results: High-flow nasal cannula use significantly reduced the rate of moderate/severe exacerbations (unadjusted mean count 1.0 vs. 2.5, a ratio of the adjusted mean count between groups [95% confidence interval] of 2.85 [1.48-5.47]) and prolonged the duration without moderate or severe exacerbations. The median time to first moderate or severe exacerbation in the long-term oxygen therapy group was 25 (14.1-47.4) weeks; this was not reached in the high-flow nasal cannula/long-term oxygen therapy group. High-flow nasal cannula use significantly improved health-related quality of life scores, peripheral oxygen saturation, and specific pulmonary function parameters. No safety concerns were identified. Conclusions: A high-flow nasal cannula is a reasonable therapeutic option for patients with stable hypercapnic chronic obstructive pulmonary disease and a history of exacerbations. Clinical trial registered with www.umin/ac.jp (UMIN000028581) and www.clinicaltrials.gov (NCT03282019) | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a chronic obstructive pulmonary disease | |
| 650 | 4 | |a hypercapnia | |
| 650 | 4 | |a oxygen inhalation therapy | |
| 650 | 4 | |a pulmonary disease | |
| 650 | 4 | |a respiratory insufficiency | |
| 650 | 7 | |a Oxygen |2 NLM | |
| 650 | 7 | |a S88TT14065 |2 NLM | |
| 700 | 1 | |a Horie, Takeo |e verfasserin |4 aut | |
| 700 | 1 | |a Chohnabayashi, Naohiko |e verfasserin |4 aut | |
| 700 | 1 | |a Jinta, Torahiko |e verfasserin |4 aut | |
| 700 | 1 | |a Tsugitomi, Ryosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Shiraki, Akira |e verfasserin |4 aut | |
| 700 | 1 | |a Tokioka, Fumiaki |e verfasserin |4 aut | |
| 700 | 1 | |a Kadowaki, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Watanabe, Akira |e verfasserin |4 aut | |
| 700 | 1 | |a Fukui, Motonari |e verfasserin |4 aut | |
| 700 | 1 | |a Kitajima, Takamasa |e verfasserin |4 aut | |
| 700 | 1 | |a Sato, Susumu |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuda, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Kishimoto, Nobuhito |e verfasserin |4 aut | |
| 700 | 1 | |a Kita, Hideo |e verfasserin |4 aut | |
| 700 | 1 | |a Mori, Yoshihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakayama, Masayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Kenichi |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuboi, Tomomasa |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshida, Makoto |e verfasserin |4 aut | |
| 700 | 1 | |a Hataji, Osamu |e verfasserin |4 aut | |
| 700 | 1 | |a Fuke, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kagajo, Michiko |e verfasserin |4 aut | |
| 700 | 1 | |a Nishine, Hiroki |e verfasserin |4 aut | |
| 700 | 1 | |a Kobayashi, Hiroyasu |e verfasserin |4 aut | |
| 700 | 1 | |a Nakamura, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Okuda, Miyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Tachibana, Sayaka |e verfasserin |4 aut | |
| 700 | 1 | |a Takata, Shohei |e verfasserin |4 aut | |
| 700 | 1 | |a Osoreda, Hisayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Minami, Kenichi |e verfasserin |4 aut | |
| 700 | 1 | |a Nishimura, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Ishida, Tadashi |e verfasserin |4 aut | |
| 700 | 1 | |a Terada, Jiro |e verfasserin |4 aut | |
| 700 | 1 | |a Takeuchi, Naoko |e verfasserin |4 aut | |
| 700 | 1 | |a Kohashi, Yasuo |e verfasserin |4 aut | |
| 700 | 1 | |a Inoue, Hiromasa |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Yoko |e verfasserin |4 aut | |
| 700 | 1 | |a Kikuchi, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Tomii, Keisuke |e verfasserin |4 aut | |
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