Delivering Oxygen to Address Acute Exacerbations of COPD

Short-term use of high-flow nasal tubes can help patients experiencing exacerbations of their chronic obstructive pulmonary disease (COPD), according to a study in Respirology.

The researchers from the Medical Research Institute of New Zealand and the University of Otago Wellington studied the effects of nasal high-flow cannulae on increased arterial carbon dioxide tension, which is a complication of acute exacerbations of COPD.

The study included 24 hospital inpatients with acute exacerbations of COPD who were receiving oxygen via nasal prongs. The patients received both supplemental oxygen via nasal high-flow cannulae at 35 L/min and standard nasal prongs for 30 minutes each. There was a 15-minute washout between each intervention.

The researchers found that patients had lower levels of retained carbon dioxide after 30 minutes of nasal high-flow cannulae compared with the standard nasal prongs.

“These findings suggest that this novel way of delivering oxygen therapy to patients with an exacerbation of COPD may result in a small reduction in carbon dioxide levels,” said Richard Beasley, MBChB, FRACP, co-author of the study, said in a statement.

Although the study found that short-term use of nasal high-flow cannulae reduced transcutaneous carbon dioxide tension by a small amount, the researchers were unsure if it was a clinically significant outcome. Furthermore, there was no difference in oxygen saturation and the reduction in respiratory rate for nasal high-flow cannulae was not statistically significant.

“Further research to assess the clinical utility of nasal high-flow oxygen therapy in patients who experience exacerbations of COPD is now a priority,” Beasley said.