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Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnic COPD
  1. Lara Pisani1,
  2. Luca Fasano2,
  3. Nadia Corcione1,
  4. Vittoria Comellini1,
  5. Muriel Assunta Musti3,
  6. Maria Brandao4,
  7. Damiano Bottone5,
  8. Edoardo Calderini6,
  9. Paolo Navalesi7,8,
  10. Stefano Nava1
  1. 1Department of Clinical, Integrated and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy
  2. 2Sant'Orsola Malpighi Hospital, Bologna, Italy
  3. 3Department of Public Health, Local Health Authority of Bologna, Bologna, Italy
  4. 4Respiratory Department, Centro Hospitar de Tràs-os-Montes e Alto Douro, São Pedro de Vila Rea, Portugal
  5. 5Respiratory Medicine Unit, Department of Clinical and Experimental Sciences, Universita’ degli Studi di Brescia, Brescia, Italy
  6. 6Department of Anesthesia and Intensive Care, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
  7. 7Department of Translational Medicine, Università del Piemonte Orientale ‘Amedeo Avogadro’, Novara, Italy
  8. 8Department of Anesthesia and Intensive Care Medicine, Sant'Andrea Hospital, Vercelli, Italy
  1. Correspondence to Professor Stefano Nava, Respiratory and Critical Care Unit, Sant'Orsola Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy; stefano.nava{at}


We studied the effects of high flow oxygen therapy (HFOT) versus non-invasive ventilation (NIV) on inspiratory effort, as assessed by measuring transdiaphragmatic pressure, breathing pattern and gas exchange. Fourteen patients with hypercapnic COPD underwent five 30-min trials: HFOT at two flow rates, both with open and closed mouth, and NIV, applied in random order. After each trial standard oxygen therapy was reinstituted for 10 min. Compared with baseline, HFOT and NIV significantly improved breathing pattern, although to different extents, and reduced inspiratory effort; however, arterial carbon dioxide oxygen tension decreased but not significantly. These results indicate a possible role for HFOT in the long-term management of patients with stable hypercapnic COPD.

Trial registration number NCT02363920.

  • Respiratory Measurement
  • Long Term Oxygen Therapy (LTOT)
  • Non invasive ventilation
  • COPD Pathology
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  • Contributors LP, study design, experimental procedure, writing and data analysis. LF, study design, data analysis. NC, data analysis and experimental procedure. VC, experimental procedure. MAM, statistical analysis. MB, experimental procedure. DB, experimental procedure. EC, data analysis and writing. PN, study design and writing. SN, study design, experimental procedure, data analysis and writing.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Comitato Etico Indipendente dell'Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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