COPD patients’ experience of long-term domestic oxygen-enriched nasal high flow treatment: A qualitative study

Storgaard, Line Margrethe Hust; Weinreich, Ulla Møller; Laursen, Birgitte Schantz

doi:10.1183/13993003.congress-2020.95

Cited by 3 publications

(8 citation statements)

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“…HFNC therapy is a relatively new mode of noninvasive respiratory support. While its role in acute respiratory disease is well described, 1,6,16 indications, outcomes, and safety in the domestic setting are still being explored 17–20 . To our knowledge, this multicenter study is the largest series to date to address the use of home HFNC therapy for chronic respiratory conditions in children.…”

Section: Discussionmentioning

confidence: 98%

High flow nasal cannula therapy in the pediatric home setting

Ehrlich

Golan‐Tripto

Lavie

et al. 2022

Pediatric Pulmonology

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Background High‐flow nasal cannula (HFNC) therapy may be better tolerated than traditional noninvasive ventilation (NIV) and is rapidly gaining acceptance in pediatric acute care. In Israel, HFNC is approved for domestic use. We aim to describe its indications, efficacy, parental satisfaction, and safety. Methods Retrospective study of children treated with home HFNC therapy in three pediatric centers. Data included demographic parameters, indication of use, weight and days of hospitalization before and after initiation. Safety, tolerability, and parental satisfaction were assessed via standardized telephone questionnaire. Results Median (interquartile range [IQR]) age of initiating home HFNC in 75 children was 8.3 (2.2, 29.6) months. Indications were obstructive sleep apnea (33; 44%), airway malacia (19; 25%), chronic lung disease (15; 20%), neuromuscular disease (4; 5%), and postextubation support (4; 5%). Weight standard deviation score rose from −2.3 pre‐HFNC to −1.7 at 6.7 months post‐HFNC initiation, p < 0.001. Hospital admission days during the 2 months pre‐ versus post‐HFNC initiation were 22 (5.5, 60) and 5 (0, 14.7) respectively, p < 0.008. Median (IQR) parental satisfaction score was 5/5 (4, 5). Fifty of 60 (83%) respondents would recommend home HFNC to other families in a similar situation. There were no serious adverse events. Conclusion In our population, domestic HFNC appeared safe and well tolerated for a variety of indications. Its introduction was associated with improved weight gain, fewer hospitalization days and high parental satisfaction. Further work is required to characterize groups of children most likely to benefit from HFNC, as opposed to traditional modes of NIV.

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Section: Discussionmentioning

confidence: 98%

High flow nasal cannula therapy in the pediatric home setting

Ehrlich

Golan‐Tripto

Lavie

et al. 2022

Pediatric Pulmonology

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“…In patients with stable COPD, the benefits of NHF include the improvement of lung mucociliary clearance, the washout of upper airway dead space, the generation of a low level of positive airway pressure (PEEP effect), the decrease in inspiratory resistance, and, at the same time, an increase in the expiratory resistance [24]. Interestingly, in patients on long-term NHF-OT, together with a reduction in symptoms, it has been reported a subjective improvement in sleep quality [32,33]. So far, data on the effect of NHF-OT on nocturnal hypoventilation in stable COPD are lacking and, as far as we know, this is the first study reporting a beneficial effect of this treatment on nocturnal hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal nasal high-flow oxygen therapy in elderly patients with concomitant chronic obstructive pulmonary disease and obstructive sleep apnea

et al. 2022

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Purpose The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is known as “overlap syndrome” (OS). Patients with OS are usually older than patients with OSA alone, suffer from more profound oxygen desaturation during the obstructive events often accompanied by sustained nocturnal hypoventilation. Although oxygen-enriched positive airway pressure (PAP) is the treatment of choice in these patients, this therapy is often poorly tolerated particularly by the elderly. The aim of this study was to assess the usefulness of nocturnal oxygen therapy via nasal high flow (NHF-OT) as a possible alternative to PAP in patients with OS. Methods Patients > 65 years old with OS and nocturnal respiratory failure (time spent below SaO2 90% (T90) > 30%) had cardio-respiratory monitoring performed at baseline, during NHF-OT, or during conventional oxygen therapy (COT). Results A total of 40 patients were enrolled in the study. NHF-OT significantly reduced the apnea–hypopnea index (AHI) in all patients compared to baseline and COT. The mean basal AHI was 25.4 ± 8.6. During COT and NHF-OT, the AHI was 19.4 ± 7 and 5.4 ± 4.6, respectively (P < 0.001) and 19 patients reached an AHI < 5 during NHF-OT. The mean nocturnal SaO2% was 86.2 ± 2.6 at baseline and at equivalent FiO2 it significantly increased to 91.8 ± 2.4 during COT and to 93.9 ± 2.5 during NHF-OT (P < 0.001). The T90% was 48.7 ± 20.1 at baseline, 16.8 ± 11.7 during COT, and 8.8 ± 8.0 during NHF-OT (P < 0.001). Conclusions In elderly patients with OS, nocturnal treatment with NHF-OT significantly reduces obstructive episodes and improves oxygenation. As the treatment is generally well tolerated compared to PAP, NHF-OT may be a possible alternative therapy in this subgroup of patients.

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“…Previously, HFNC-treated patients with COPD have expressed improved QoS. 19 Although a recent study concluded that patients with ILD have poor sleep quality, 37 there may be differences between the two disease entities. Furthermore, the RCSQ is not validated in domiciliary HFNC treatment, but the score was chosen as it included “noise” as a parameter affecting sleep.…”

Section: Discussionmentioning

confidence: 99%

“… 39 This is in line with a previous qualitative study where patients with severe COPD expressed the ease of use of HFNC. 19 One patient used HFNC very little. The patient had not complained of any difficulties at the 1-week interview, nor had he made any complaint to the service company.…”

Section: Discussionmentioning

confidence: 99%

“…Here reduction in number of exacerbations prolonged time to first exacerbation; 14 improved Forced Expiratory Volume in the first second (FEV1) and mucus retention challenges, 15 in addition to a reduction in respiratory rate, 16 PaCO2 17 and increased exercise performance 18 has been shown, in addition to improved health-related quality of life (HR-QoL) and -sleep quality. 14 , 19 …”

Section: Introductionmentioning

confidence: 99%

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The effect of domiciliary high flow nasal cannula treatment on dyspnea and walking distance in patients with interstitial lung disease – A pilot study

2022

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Introduction Interstitial Lung Diseases (ILD) affect the lung parenchyma and are often complicated by respiratory failure (RF) and impaired physical activity. High Flow Nasal Cannula (HFNC) has proved effective in other disease entities with RF. The aim of this study is to investigate the effect of domiciliary HFNC in ILD on dyspnea and walking distance. Methods A 6 weeks cross-over study with domiciliary HFNC-treatment/6 weeks’ observation in ILD-patients requiring ambulatory oxygen therapy or with newly prescribed (within 12 months) long term oxygen therapy. Patients were advised to use HFNC 8 h/day, recommended night-time use. Body phletysmography; 6-min walk test (6MWT) including BORG-score, oxygen saturation (SO2) at start, minimum SO2 and time to recovery after 6MWT; arterial blood gasses; modified Medical Research Council (mMRC)-score; quality of life, by the St George Respiratory Questionnaire (SGRQ) and QoS, by the Richards-Campbell Sleep Questionnaire (RCSQ) were investigated at baseline; six weeks and 12 weeks. Results 10 patients were included; one later withdrew consent. Patients used HFNC between 8-<1 h/day. There were no differences in lung function; blood gasses; SGRQ or RCSQ over the observational period). Walking distance improved significantly (393–441 m p = 0.049) as did time to recovery (3.4–2-2 min, p = 0.001). When correcting for HFNC use (hours/day) significant improvement was also seen in mMRC-score ( p = 0.035) and minimum saturation during 6MWT ( p = 0.01). Conclusion Despite a very heterogenous group and no effect on quality of life and -sleep, the study indicates an improvement in dyspnea and physical ability of HFNC in ILD patients.

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COPD patients’ experience of long-term domestic oxygen-enriched nasal high flow treatment: A qualitative study

Cited by 3 publications

References 0 publications

High flow nasal cannula therapy in the pediatric home setting

High flow nasal cannula therapy in the pediatric home setting

Nocturnal nasal high-flow oxygen therapy in elderly patients with concomitant chronic obstructive pulmonary disease and obstructive sleep apnea

The effect of domiciliary high flow nasal cannula treatment on dyspnea and walking distance in patients with interstitial lung disease – A pilot study

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