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

Abstract

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.

Long-Term High Flow Nasal Cannula Therapy in Primary and Secondary Bronchiectasis

“…There is limited evidence on long-term HFNC for chronic respiratory diseases, especially bronchiectasis. In a 6 weeks crossover study, 10 patients affected by interstitial lung disease (ILD) and chronic respiratory failure were treated with domiciliary HFNC; authors observed no differences in lung function and blood gasses, but walking distance at 6-min walking test (6 MWT) improved significantly [13]. Similarly, Chihara et al reported an improvement in walking distance following four weeks of exercise training using an HFNC; in this study, HFNC was set with a flow of 50 L/min, and FiO2 was 1.0, involving chronic respiratory failure [14].…”

High-Flow Nasal Cannula System in Respiratory Failure Associated with Interstitial Lung Diseases: A Systematic Review and Narrative Synthesis

“…Additionally, the study observed favorable changes in the mMRC score, Borg score, and distance covered during the 6MWT after HFNC therapy, indicating an overall enhancement in exercise capacity and respiratory comfort. However, no significant improvement in lung function was found [29]. Another study evaluated the impact of HFNC on exercise capacity in fibrotic ILD patients.…”

Home-based respiratory support

“…Der arbejdes med LT-HFNC til andre patientgrupper, f.eks. patienter med bronkiektasi og interstitiel lungesygdom [13, [19][20][21][22][23][24][25]. Ved…”