COPD, Small Airway Disorders
Conditions
Keywords
high-flow nasal cannula, high nasal flow, chronic obstructive pulmonary disease (COPD), airway impedance, distal airway, peripheral airway, airway resistance
Brief summary
In addition to pharmacological treatment, nonpharmacological treatment with high-flow nasal cannula (HFNC) may play a vital role in the treatment of patients with chronic obstructive pulmonary disease (COPD). The impulse oscillation system (IOS) is new noninvasive technique to measure the impedance of different portions of the airway with higher sensitivity than that of the conventional pulmonary function test (PFT). However, whether IOS is an appropriate technique to evaluate the efficacy of HFNC in improving the impedance of peripheral small airways in patients with COPD is unclear.
Detailed description
Participants with stable COPD from the chest medicine outpatient department will be randomized into two groups receiving HFNC or nasal cannula (NC) for 10 min followed by a 4-week washout period and crossover alternatively. We used a novel analytical measurement technique, IOS, to detect the difference in airway impedance in the participants after the HFNC or NC interventions. All data, namely IOS parameters, transcutaneous partial pressure of carbon dioxide, peripheral oxygen saturation, body temperature, respiratory rate, pulse rate, blood pressure, and PFT results at the time of pre-HFNC, post-HFNC, pre-NC, and post-NC, were analysed using SPSS (version 25.0, IBM, Armonk, NY, USA).
Interventions
HFNC was administered using the MyAIRVO 2 device (Fisher & Paykel Healthcare, Auckland, New Zealand), which provides humidification and high-flow medical gas through an Optiflow NC interface (Fisher & Paykel Healthcare, Auckland, New Zealand) is administered for 10 min.. NC is administered for 10 min.
Sponsors
Study design
Eligibility
Inclusion criteria
* age of 20 to 75 years old * diagnosis of COPD made by pulmonologist (Kuo YL) if the patient had a long-term smoking or noxious gas exposure history, typical clinical manifestations, and airflow limitation with a postbronchodilator FEV1/FVC ratio of \< 0.7 in spirometry,4 and * provision of written informed consent.
Exclusion criteria
* severe and unstable comorbidities or active malignancy * history of obstructive sleep apnoea syndrome * COPD exacerbation within the 4 weeks prior * current use of long-term oxygen therapy or noninvasive ventilation or use within the 6 weeks prior * cognitive impairment or a psychiatric disorder * pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| R5 | immediately after 10 minutes of HFNC or NC | Changes of R5 |
| R5% | immediately after 10 minutes of HFNC or NC | Changes of R5% |
| R20 | immediately after 10 minutes of HFNC or NC | Changes of R20 |
| R20% | immediately after 10 minutes of HFNC or NC | Changes of R20% |
| Changes of R5-20 | immediately after 10 minutes of HFNC or NC | R5-20 |
| X5-predicted | immediately after 10 minutes of HFNC or NC | Changes of X5-predicted |
| X5-predicted% | immediately after 10 minutes of HFNC or NC | Changes of X5-predicted% |
| Changes of Fres | immediately after 10 minutes of HFNC or NC | Fres |
| Changes of Fres% | immediately after 10 minutes of HFNC or NC | Fres% |
| Changes of Ax | immediately after 10 minutes of HFNC or NC | Ax |
| Ax% | immediately after 10 minutes of HFNC or NC | Changes of Ax% |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes of FEV3 | immediately after 10 minutes of HFNC or NC | FEV3 |
| FEV3% | immediately after 10 minutes of HFNC or NC | Changes of FEV3% |
| FEV3/FVC% | immediately after 10 minutes of HFNC or NC | Changes of FEV3/FVC% |
| TcPCO2 | immediately after 10 minutes of HFNC or NC | Changes of TcPCO2 |
| Changes of MMEF% | immediately after 10 minutes of HFNC or NC | MMEF% |
| PEF | immediately after 10 minutes of HFNC or NC | Changes of PEF |
| PEF% | immediately after 10 minutes of HFNC or NC | Changes of PEF% |
| MMEF | immediately after 10 minutes of HFNC or NC | Changes of MMEF |
| Body temperature | immediately after 10 minutes of HFNC or NC | Changes of body temperature |
| pulse rate | immediately after 10 minutes of HFNC or NC | Changes of pulse rate |
| respiratory rate | immediately after 10 minutes of HFNC or NC | Changes of respiratory rate |
| both systolic and diastolic blood pressure | immediately after 10 minutes of HFNC or NC | Changes of both systolic and diastolic blood pressure |
| SpO2 | immediately after 10 minutes of HFNC or NC | Changes of SpO2 |
| FEV1 | immediately after 10 minutes of HFNC or NC | Changes of FEV1 |
| FEV1% | immediately after 10 minutes of HFNC or NC | Changes of FEV1% |
| FVC | immediately after 10 minutes of HFNC or NC | Changes of FVC |
| FVC% | immediately after 10 minutes of HFNC or NC | Changes of FVC% |
| FEV1/FVC% | immediately after 10 minutes of HFNC or NC | Changes of FEV1/FVC% |
Countries
Taiwan