High Flow Nasal Therapy Use in Patients with Acute Exacerbation of COPD and Bronchiectasis: A Feasibility Study

Figures & data

Figure 1. Study design flow-chart and patients selection.

ARF: acute respiratory failure; AECOPD: acute exacerbation chronic obstructive pulmonary disease; HRCT: high resolution computed tomography; RR: respiratory rate; NIV: noninvasive ventilation; ED: emergency department; HFNT: high flow nasal cannula; ABG: arterial blood gas analysis; VAS: visual analogic scale.

Table 1. Patients’ characteristics.

Sex male/female	8/7
Age	69 (4)
BMI	25 (5)
FEV1 % of predicted	37% (7)
FVC % of predicted	63% (12)
FEV1/FVC	0.60 (0.05)
Smoking status
Current	7
Ex	8
GOLD group
C	2
D	13
GOLD grade
3	5
4	10
Pack*years	45 (30-50)
>3 Exacerbations/y	13
Hospitalization last 12 months	8
MRC	4 (3-5)
CAT	31 (5)
Charlson Index	4 (1)
LTOT	10
LTOT (l/min)	1.6 (0.5)

Data are presented as absolute numbers, or mean (standard deviation), or median (upper-lower quartiles).

BMI: Body Mass Index.

GOLD: Global Initiative for Chronic Obstructive Lung Disease.

MRC: medical research council.

CAT: COPD assessment test.

LTOT: Long Term Oxygen Therapy.

GOLD group: classification based on ABCD assessment tool.

GOLD grade: classification based on airflow limitation severity.

Table 2. Bronchiectasis details.

Lobes involved on CT	2.5 (1.3)
Distribution
Peripheral	11
Central	0
Diffuse	4
Bilateral	14
Degree of dilatation
Tubular	14
Varicose	1
Cystic	0
BSI score	9.2 (3.2)
Mild (0-4)	0
Moderate (5-8)	7
Severe (>9)	8

Data are presented as absolute numbers, or mean (standard deviation), or median (upper-lower quartiles).

BSI: Bronchiectasis severity index.

Figure 2. Changes of RR, BORG scale, pO2, pCO2 at baseline and at different time points during HFNT treatment. RR: respiratory rate; HFNT: high flow nasal therapy.

Table 3. Assessment of study outcomes at the different time-points.

	Baseline	1h	24h	48h	72h	p
RR (breaths/min)	29.6 (2.7)	26.2* (2.7)	23.1* (2.9)	21.3 (3.3)	19.6 (2.3)	<0.001
pH	7.40 (0.03)	7.41 (0.03)	7.42 (0.02)	7.42 (0.02)	7.42 (0.02)	0.02
pCO2 (mmHg)	58.4 (13)	53.9* (9.1)	51.6* (8.2)	48.9* (7.3)	47.9 (6.5)	<0.001
pO2 (mmHg)	61.9 (4.8)	65.3 (1.6)	67.1 (2.1)	67.8 (2.4)	68.6^# (2.6)	<0.001
BORG Score	6.7 (1.4)	4.9* (1.6)	4.1* (1.3)	3.3 (1.2)	3 (1)	<0.001
Mucus Quantity	1.1 (0.6)	2.1* (0.7)	2.4 (0.7)	2.5 (0.7)	2.3 (0.7)	<0.001
Ease expectoration	4 (1.3)	5.5* (1.3)	6 (1.5)	6.5 (1.8)	6.8^# (1.7)	< 0.001
Device Tolerance	–	6.2 (1.2)	6.6 (1.1)	6.7 (1.1)	6.7 (1.1)	0.02

Mean (SD), p value was calculated assuming sphericity or Greenhouse-Geisser correction.

*Statistically different from the previous time-point.

^#Different from baseline.

RR: respiratory rate.

Figure 3. Changes of mucus production and patients’ self-reported ease of sputum expectoration at baseline and at different time points during HFNT.