The Use of High-Flow Nasal Oxygen Therapy in the Management of Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Feasibility Study


Hancı P., Öcal S., Kaya E. K., Topeli A.

Turkish Thoracic Journal, cilt.23, sa.5, ss.336-342, 2022 (Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 23 Sayı: 5
  • Basım Tarihi: 2022
  • Doi Numarası: 10.5152/turkthoracj.2022.21268
  • Dergi Adı: Turkish Thoracic Journal
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.336-342
  • Anahtar Kelimeler: chronic obstructive pulmonary disease, critical care, critically ill, intensive care, Oxygen inhalation therapy, pneumonia
  • Trakya Üniversitesi Adresli: Evet

Özet

OBJECTIVE: This study investigated the efficacy of high-flow nasal oxygen therapy in patients with severe acute exacerbation of chronic obstructive pulmonary disease admitted to the intensive care unit. MATERIAL AND METHODS: Totally, 23 patients were enrolled in the study. High-flow nasal oxygen therapy was administered with a predefined protocol. Vital signs, Visual Analog Scale for dyspnea, and arterial blood gas parameters were recorded at the beginning under low-flow oxygen support therapy and the 1st, 6th, 12th, and 24th hours of high-flow nasal oxygen therapy. High-flow nasal oxygen therapy duration, intensive care unit length of stay, and intensive care unit, in-hospital, and 60-day mortality were recorded as outcomes and compared according to the presence of pneumonia upon admission. RESULTS: In 12 patients (52.2%), pneumonia was present. High-flow nasal oxygen therapy was applied for a median of 57 hours [49.2-104.5]. Overall decreases were detected in heart rate (P = .001), respiratory rate (P < .001), and Visual Analog Scale for dyspnea (P = .001) during the first 24 hours of the therapy. Although there was an increase in PaCO2 (P = .001), pH increased (P < .001) over time too. No change in partial arterial oxygen pressure (P = .63) and partial arterial oxygen pressure/fraction of inspired oxygen ratio (P = .22) was noted. Nineteen patients (77%) were successfully weaned from high-flow nasal oxygen therapy. While the high-flow nasal oxygen therapy failure rate was 23%, the in-hospital and 60-day mortality rates were 8.6%. Outcomes were not different between patients with and without pneumonia. CONCLUSION: High-flow nasal oxygen therapy was efficient in relieving respiratory distress and well-tolerated with no adverse outcome in severe acute exacerbation of chronic obstructive pulmonary disease patients admitted to the intensive care unit.