Tags

Type your tag names separated by a space and hit enter

High flow through nasal cannula in exacerbated COPD patients: a systematic review.
Pulmonology 2019 Nov - Dec; 25(6):348-354P

Abstract

Chronic Obstructive Pulmonary Disease (COPD) history is characterized by episodes of exacerbation of varying severity, featured by acute worsening of respiratory symptoms, commonly precipitated by respiratory tract infection. The recent ERS/ATS clinical practice guidelines strongly recommend the application of non invasive ventilation (NIV) for patients with acute respiratory failure (ARF) leading to acute or acute-on-chronic respiratory acidosis (pH 7.35) and not for those patients with acute exacerbation of COPD (AECOPD) and hypercapnia who are not acidotic. In recent years, High-Flow through Nasal Cannula (HFNC) has been introduced in the clinical practice. We designed the present systematic review of the literature to assess all effects of HFNC use reported in exacerbated COPD patients. In this setting, HFNC is able to keep PaCO2 unmodified, while oxygenation slightly deteriorates as opposed to NIV. Furthermore, the work of breathing is reduced with HFNC by a similar extent to NIV, while it increases by 40-50% during conventional oxygen therapy (COT). HFNC is also reported to be more comfortable than COT and NIV. Despite these results, little and limited evidence for improved clinical outcomes is currently available.

Authors+Show Affiliations

Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy. Electronic address: lara.pisani@aosp.bo.it.Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Alma Mater University, Bologna, Italy.Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31591056

Citation

Pisani, L, et al. "High Flow Through Nasal Cannula in Exacerbated COPD Patients: a Systematic Review." Pulmonology, vol. 25, no. 6, 2019, pp. 348-354.
Pisani L, Astuto M, Prediletto I, et al. High flow through nasal cannula in exacerbated COPD patients: a systematic review. Pulmonology. 2019;25(6):348-354.
Pisani, L., Astuto, M., Prediletto, I., & Longhini, F. (2019). High flow through nasal cannula in exacerbated COPD patients: a systematic review. Pulmonology, 25(6), pp. 348-354. doi:10.1016/j.pulmoe.2019.08.001.
Pisani L, et al. High Flow Through Nasal Cannula in Exacerbated COPD Patients: a Systematic Review. Pulmonology. 2019;25(6):348-354. PubMed PMID: 31591056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High flow through nasal cannula in exacerbated COPD patients: a systematic review. AU - Pisani,L, AU - Astuto,M, AU - Prediletto,I, AU - Longhini,F, Y1 - 2019/10/05/ PY - 2019/08/07/received PY - 2019/08/20/revised PY - 2019/08/20/accepted PY - 2019/10/9/pubmed PY - 2019/10/9/medline PY - 2019/10/9/entrez KW - Chronic obstructive pulmonary disease KW - High flow nasal cannula KW - Hypercapnia KW - Non-invasive ventilation KW - Oxygen KW - Positive-pressure respiration KW - Respiratory insufficiency KW - Respiratory therapy SP - 348 EP - 354 JF - Pulmonology JO - Pulmonology VL - 25 IS - 6 N2 - Chronic Obstructive Pulmonary Disease (COPD) history is characterized by episodes of exacerbation of varying severity, featured by acute worsening of respiratory symptoms, commonly precipitated by respiratory tract infection. The recent ERS/ATS clinical practice guidelines strongly recommend the application of non invasive ventilation (NIV) for patients with acute respiratory failure (ARF) leading to acute or acute-on-chronic respiratory acidosis (pH 7.35) and not for those patients with acute exacerbation of COPD (AECOPD) and hypercapnia who are not acidotic. In recent years, High-Flow through Nasal Cannula (HFNC) has been introduced in the clinical practice. We designed the present systematic review of the literature to assess all effects of HFNC use reported in exacerbated COPD patients. In this setting, HFNC is able to keep PaCO2 unmodified, while oxygenation slightly deteriorates as opposed to NIV. Furthermore, the work of breathing is reduced with HFNC by a similar extent to NIV, while it increases by 40-50% during conventional oxygen therapy (COT). HFNC is also reported to be more comfortable than COT and NIV. Despite these results, little and limited evidence for improved clinical outcomes is currently available. SN - 2531-0437 UR - https://www.unboundmedicine.com/medline/citation/31591056/High_flow_through_nasal_cannula_in_exacerbated_COPD_patients:_a_systematic_review L2 - https://linkinghub.elsevier.com/retrieve/pii/S2531-0437(19)30163-1 DB - PRIME DP - Unbound Medicine ER -