High flow nasal cannula improves breathing efficiency and ventilatory ratio in COPD patients recovering from an exacerbation.
Details
Serval ID
serval:BIB_CE3FB0C83DD2
Type
Article: article from journal or magazin.
Publication sub-type
Letter (letter): Communication to the publisher.
Collection
Publications
Institution
Title
High flow nasal cannula improves breathing efficiency and ventilatory ratio in COPD patients recovering from an exacerbation.
Journal
Journal of critical care
ISSN
1557-8615 (Electronic)
ISSN-L
0883-9441
Publication state
Published
Issued date
06/2022
Peer-reviewed
Oui
Volume
69
Pages
154023
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
High flow nasal cannula (HFNC) may improve CO <sub>2</sub> elimination by washing out CO <sub>2</sub> from the upper airways. This study aimed at assessing the effect of HFNC on minute ventilation and ventilatory ratio (VR), a surrogate of dead space, in patients hospitalized for acute hypercapnic COPD exacerbation.
Physiological study comparing HFNC at 40 L/min to low flow oxygen. Variations of tidal volume (VT) and minute ventilation between the two treatments were estimated from chest plethysmography. Respiratory rate (RR) and arterial blood gases were measured. Variations in VR were calculated. Data were compared using Wilcoxon tests.
Recordings performed in 10 patients. Minute ventilation was reduced with HFNC by -16.2 [-30.9-0.4] % (p = 0.049). VT was not different but RR was lower during HFNC. PaCO <sub>2</sub> was lower with HFNC compared to standard oxygen: 48.7 [46.4-58.1] vs 50.7 [48.4-57.5] mmHg (p = 0.020). VR decreased by -18.0 [-34.7 - -4.0] % (p = 0.020) with HFNC.
In patients recovering from acute COPD exacerbation, the use of HFNC reduced RR, minute ventilation, PaCO <sub>2</sub> and VR compared to standard oxygen. These changes are consistent with a decrease in physiologic dead space with HFNC.
Physiological study comparing HFNC at 40 L/min to low flow oxygen. Variations of tidal volume (VT) and minute ventilation between the two treatments were estimated from chest plethysmography. Respiratory rate (RR) and arterial blood gases were measured. Variations in VR were calculated. Data were compared using Wilcoxon tests.
Recordings performed in 10 patients. Minute ventilation was reduced with HFNC by -16.2 [-30.9-0.4] % (p = 0.049). VT was not different but RR was lower during HFNC. PaCO <sub>2</sub> was lower with HFNC compared to standard oxygen: 48.7 [46.4-58.1] vs 50.7 [48.4-57.5] mmHg (p = 0.020). VR decreased by -18.0 [-34.7 - -4.0] % (p = 0.020) with HFNC.
In patients recovering from acute COPD exacerbation, the use of HFNC reduced RR, minute ventilation, PaCO <sub>2</sub> and VR compared to standard oxygen. These changes are consistent with a decrease in physiologic dead space with HFNC.
Keywords
Cannula, Carbon Dioxide, Humans, Noninvasive Ventilation, Oxygen, Oxygen Inhalation Therapy, Pulmonary Disease, Chronic Obstructive/therapy, Respiratory Insufficiency/therapy
Pubmed
Web of science
Create date
09/04/2022 18:21
Last modification date
21/03/2023 6:47
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