Home High-Flow Nasal Cannula Oxygen Therapy for Stable Hypercapnic COPD

被引：71

作者：

Nagata, Kazuma ^{[1
]}

Horie, Takeo ^{[2
]}

Chohnabayashi, Naohiko ^{[3
]}

Jinta, Torahiko ^{[3
]}

Tsugitomi, Ryosuke ^{[3
]}

Shiraki, Akira ^{[4
]}

Tokioka, Fumiaki ^{[5
]}

Kadowaki, Toru ^{[6
]}

Watanabe, Akira ^{[7
]}

Fukui, Motonari ^{[8
]}

Kitajima, Takamasa ^{[8
]}

Sato, Susumu ^{[9
]}

Tsuda, Toru ^{[10
]}

Kishimoto, Nobuhito ^{[11
]}

Kita, Hideo ^{[12
]}

Mori, Yoshihiro ^{[13
]}

Nakayama, Masayuki ^{[14
]}

Takahashi, Kenichi ^{[15
]}

Tsuboi, Tomomasa ^{[16
]}

Yoshida, Makoto ^{[17
]}

Hataji, Osamu ^{[18
]}

Fuke, Satoshi ^{[19
]}

Kagajo, Michiko ^{[4
]}

Nishine, Hiroki ^{[20
]}

Kobayashi, Hiroyasu ^{[21
]}

Nakamura, Hiroyuki ^{[22
]}

Okuda, Miyuki ^{[23
]}

Tachibana, Sayaka ^{[24
]}

Takata, Shohei ^{[25
]}

Osoreda, Hisayuki ^{[26
]}

Minami, Kenichi ^{[27
]}

Nishimura, Takashi ^{[28
]}

Ishida, Tadashi ^{[5
]}

Terada, Jiro ^{[29
]}

Takeuchi, Naoko ^{[30
]}

Kohashi, Yasuo ^{[31
]}

Inoue, Hiromasa ^{[32
]}

Nakagawa, Yoko ^{[33
]}

Kikuchi, Takashi ^{[33
]}

Tomii, Keisuke ^{[1
]}

机构：

[1] Kobe City Med Ctr Gen Hosp, Dept Resp Med, Kobe, Hyogo, Japan

[2] Japanese Red Cross Maebashi Hosp, Dept Resp Med, Maebashi, Gunma, Japan

[3] St Lukes Int Hosp, Div Pulm Med, Thorac Ctr, Chuo Ku, Tokyo, Japan

[4] Ogaki Municipal Hosp, Dept Resp Med, Gifu, Japan

[5] Kurashiki Cent Hosp, Dept Resp Med, Kurashiki, Okayama, Japan

[6] Natl Hosp Org, Dept Pulm Med, Matsue Med Ctr, Matsue, Shimane, Japan

[7] Natl Hosp Org, Dept Resp Med, Ehime Med Ctr, Toon, Ehime, Japan

[8] Tazuke Kofukai Fdn, Med Res Inst, Kitano Hosp, Resp Dis Ctr, Osaka, Osaka, Japan

[9] Kyoto Univ, Grad Sch Med, Dept Resp Med, Kyoto, Kyoto, Japan

[10] Kirigaoka Tsuda Hosp, Kitakyushu, Fukuoka, Japan

[11] Takamastu Municipal Hosp, Dept Resp Med, Takamatsu, Kagawa, Japan

[12] Takatsuki Red Cross Hosp, Dept Resp Med, Takatsuki, Osaka, Japan

[13] KKR Takamatsu Hosp, Dept Resp Med, Takamatsu, Kagawa, Japan

[14] Jichi Med Univ, Div Pulm Med, Dept Med, Shimotsuke, Tochigi, Japan

[15] Kishiwada City Hosp, Kishiwada, Osaka, Japan

[16] Natl Hosp Org, Minami Kyoto Hosp, Dept Resp Med, Joyo, Kyoto, Japan

[17] Natl Hosp Org, Fukuoka Natl Hosp, Dept Resp Med, Fukuoka, Fukuoka, Japan

[18] Matsusaka Municipal Hosp, Resp Ctr, Matsusaka, Mie, Japan

[19] KKR Sapporo Med Ctr, Dept Resp Med, Sapporo, Hokkaido, Japan

[20] St Marianna Univ, Div Resp Med, Dept Internal Med, Sch Med, Kawasaki, Kanagawa, Japan

[21] Suzuka Gen Hosp, Resp Ctr, Suzuka, Mie, Japan

[22] Sakaide City Hosp, Dept Resp Med, Sakaide, Kagawa, Japan

[23] Osaka Anti TB Assoc, Osaka Hosp, Neyagawa, Osaka, Japan

[24] Ehime Prefectural Cent Hosp, Dept Resp Med, Matsuyama, Ehime, Japan

[25] Natl Hosp Org, Dept Resp Med, Fukuokahigashi Med Ctr, Koga, Fukuoka, Japan

[26] Natl Hosp Org, Dept Resp Med, Yamaguchi Ube Med Ctr, Ube, Yamaguchi, Japan

[27] Ishikiriseiki Hosp, Dept Resp Med, Osaka, Japan

[28] Kyoto Katsura Hosp, Dept Resp Med, Kyoto, Kyoto, Japan

[29] Chiba Univ, Grad Sch Med, Dept Respirol, Chiba, Chiba, Japan

[30] Natl Hosp Org, Dept Internal Med, Kinki Chuo Chest Med Ctr, Sakai, Osaka, Japan

[31] HARUHI Resp Med Hosp, Dept Resp Med, Kiyosu, Aichi, Japan

[32] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Pulm Med, Kagoshima, Kagoshima, Japan

[33] Fdn Biomed Res & Innovat, Div Med Stat, Translat Res Ctr Med Innovat, Kobe, Hyogo, Japan

来源：

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE | 2022年 / 206卷 / 11期

关键词：

chronic obstructive pulmonary disease; hypercapnia; oxygen inhalation therapy; pulmonary disease; respiratory insufficiency; OBSTRUCTIVE PULMONARY-DISEASE; SLEEP QUALITY INDEX; NATURAL-HISTORY; EXACERBATIONS; GUIDELINES; VERSION;

D O I：

10.1164/rccm.202201-0199OC

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Rationale: The long-term effects of using a high-flow nasal cannula for chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease remain unclear. Objectives: To assess whether long-term high-flow nasal cannula use reduces the number of exacerbations and improves other physiological parameters in patients with chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease. Methods: We enrolled 104 participants (aged >= 40 yr) with daytime hypercapnia (Global Initiative for Chronic Obstructive Lung Disease stages 2-4) receiving long-term oxygen therapy (>= 16 h/d for >= 1 mo) and randomly assigned them to high-flow nasal cannula/long-term oxygen therapy and long-term oxygen therapy groups. The primary endpoint was the moderate or severe exacerbation rate. We compared changes from baseline in arterial blood gas values, peripheral oxygen saturation, pulmonary function, health-related quality-of-life scores, and the 6-minute-walk test. Measurements and Main Results: High-flow nasal cannula use significantly reduced the rate of moderate/severe exacerbations (unadjusted mean count 1.0 vs. 2.5, a ratio of the adjusted mean count between groups [95% confidence interval ] of 2.85 [1.48-5.47]) and prolonged the duration without moderate or severe exacerbations. The median time to first moderate or severe exacerbation in the long-term oxygen therapy group was 25 (14.1-47.4) weeks; this was not reached in the high-flow nasal cannula/long-term oxygen therapy group. High-flow nasal cannula use significantly improved health-related quality of life scores, peripheral oxygen saturation, and specific pulmonary function parameters. No safety concerns were identified. Conclusions: A high-flow nasal cannula is a reasonable therapeutic option for patients with stable hypercapnic chronic obstructive pulmonary disease and a history of exacerbations.

引用

页码：1326 / 1335

页数：10

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