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High-flow humidified therapy for COPD at home
Home non-invasive ventilation (NIV) improves outcomes in patients with COPD and chronic hypercapnia; however, it is not always well tolerated. High-flow humidified therapy (HFH) offers an alternative more acceptable long-term therapy in these patients. Pisani and colleagues (BMC Pulmonary Medicine 2020:20;12) report on the acceptability of HFH to patients and its effectiveness on PaCO2 reduction. In a pilot study, 50 patients recovering from an acute exacerbation of COPD requiring hospital admission, with persistent hypercapnia but normalised pH on three occasions, were enrolled and started on HFH. An a priori analysis of patients with and without COPD–OSA (obstructive sleep apnoea) overlap was planned. For a 72-hour period, each participant used HFH overnight, plus >8 hours during daytime. Each morning, arterial blood gas result, number of hours of HFH and patient-reported tolerance to therapy (scored 1–5; very bad–very good) were recorded. The therapy was tolerated well by all but one participant (mean patient score 4.0±0.9). Results showed no significant difference in PaCO2 from baseline overall; however, in patients with COPD without OSA (n=38), PaCO2 was reduced by ~6 mm Hg (0.8 kPa); p=0.044 at 72 hours. With a lack of control …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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