Nasal high flow does not improve exercise tolerance in COPD patients recovering from acute exacerbation: A randomized crossover study. Issue 11 (6th August 2019)

• Record Type: Journal Article
• Authors: Prieur, Guillaume; Medrinal, Clement; Combret, Yann; Dupuis Lozeron, Elise; Bonnevie, Tristan; Gravier, Francis‐Edouard; Quieffin, Jean; Lamia, Bouchra; Borel, Jean‐Christian; Reychler, Gregory
• Is Part Of: Respirology. Volume 24:Issue 11(2019)
• Page Start: 1088
• Page End: 1094
• Publication Date: 2019-08-06
• Subjects: chronic obstructive pulmonary disease -- exercise -- muscle oxygenation -- nasal high flow -- pulmonary rehabilitation; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.13664
• Languages: English
• ISSNs: 1323-7799

Abstract

ABSTRACT: Background and objective: We hypothesized that by reducing respiratory work and improving gas exchange, nasal high flow (NHF) would improve exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) following respiratory exacerbation. Methods: This was a monocentric, randomized, controlled crossover study. Patients with severe to very severe COPD carried out two high‐intensity constant work‐rate exercise tests (CWRET) with and without NHF on two consecutive days. The primary outcome was the mean difference in endurance time between both conditions. The secondary aims included vastus lateralis oxygenation (StO2 ), dyspnoea, leg discomfort, maximal inspiratory pressure (MIP), transcutaneous CO2 pressure (PtcCO2 ), respiratory rate (RR), heart rate (HR) and pulsed O2 saturation (SpO2 ), as well as the patients' opinions of the device. Results: A total of 19 patients were included (mean forced expiratory volume in 1 s = 28.7 ± 10.8%, age = 62.1 ± 9.1 years). No significant differences in endurance time during the CWRET were found between the two test conditions (−66.58 (95% CI: −155.9 to 22.7) s, P = 0.12). StO2, PtCO2 and HR were reduced at the end of the exercise with NHF (−2.1% (95% CI: −4.3 to −0.0); −1.3 mm Hg (95% CI: −2.5 to −0.2); −2.7 bpm (95% CI: −5.0 to −0.5), respectively, P ≤ 0.05). No significant differences were found for any of the other secondary outcomes. Half of the patients evaluated the device as being moderately to very uncomfortable. Conclusion: NHF during exercise did not increase endurance time in patients with COPD following exacerbation. Clinical trial registration: NCT03058081 atclinicaltrials.gov Abstract : The addition of nasal high flow during high‐intensity exercise does not improve endurance in patients with chronic obstructive pulmonary disease participating in pulmonary rehabilitation following exacerbation. See related Editorial