Effectiveness of high-flow nasal cannula on pulmonary rehabilitation in subjects with chronic respiratory failure

• Published in: Respiratory investigation Vol. 60; no. 5; pp. 658 - 666
• Main Authors: Chihara, Yuichi, Tsuboi, Tomomasa, Sumi, Kensuke, Sato, Atsuo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2022
• Subjects: 6-min walking distance; Chronic respiratory failure; Exercise training; High-flow nasal cannula; Long-term oxygen therapy; 6-min walking distance; 6 MWT; ABG; FIO2; SpO2; Long-term oxygen therapy; LTOT; HFNC; 6 MWD; PtcCO2; CRF; Exercise training; High-flow nasal cannula; Chronic respiratory failure; IPF; COPD
• ISSN: 2212-5345; 2212-5353; 2212-5353
• DOI: 10.1016/j.resinv.2022.05.002

The effects of exercise training using both high fraction of inspired oxygen (FIO2) and high flow oxygen delivered through a high-flow nasal cannula (HFNC) on exercise capacity in patients with chronic respiratory failure (CRF) receiving long-term oxygen therapy (LTOT) are unknown. In this randomized study, 32 patients with CRF receiving LTOT were assigned to undergo 4 weeks of exercise training on a cycle ergometer using an HFNC (flow: 50 L/min) with a FIO2 of 1.0 (HFNC group; n = 16) or ordinary supplemental oxygen via a nasal cannula (flow: 6 L/min) (oxygen group; n = 16). A 6-min walking test and a constant-load test were performed before and after 4 weeks of exercise training. Following 4 weeks of exercise training, change in the 6-min walking distance was significantly greater in the HFNC than in the oxygen group (55.2 ± 69.6 m vs. −0.5 ± 87.3 m; p = 0.04). However, there was no significant difference between the two groups in the degree of improvement in the duration of the constant-load exercise test after exercise training. Considering the effect on daily activities (e.g., walking), exercise training using both high FIO2 and high flow through an HFNC is a potentially superior exercise training modality for patients with CRF receiving LTOT. Clinical Trial Registration — http://www.clinicaltrials.gov. Unique identifier: NCT02804243