Guillaume Prieur1,2,3,4, Clement Medrinal2,3,4, Yann Combret1,5, Elise Dupuis Lozeron6, Tristan Bonnevie2,7, Francis-Edouard Gravier2,7, Jean Quieffin3,4, Bouchra Lamia2,3,4, Jean-Christian Borel8,9, Gregory Reychler1,10. 1. Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL and Dermatologie, Groupe de Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, Brussels, Belgium. 2. Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, Rouen, France. 3. Pulmonology Department, Groupe Hospitalier du Havre, Montivilliers, France. 4. Pulmonary Rehabilitation Department, Groupe Hospitalier du Havre, Montivilliers, France. 5. Physiotherapy Department, Groupe Hospitalier du Havre, Montivilliers, France. 6. Division of Clinical Epidemiology, Geneva University Hospitals, Geneva, Switzerland. 7. ADIR Association, Rouen University Hospital, Rouen, France. 8. Association AGIR à dom, Research and Development, Meylan, France. 9. HP2 INSERMU 1042, Grenoble, France. 10. Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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 at clinicaltrials.gov.
RCT Entities:
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 at clinicaltrials.gov.