Feasibility of Using Daily Home High-Flow Nasal Therapy in COPD Patients Following a Recent COPD Hospitalization.

Rationale High-flow nasal therapy (HFNT) has beneficial effects in patients hospitalized with acute hypoxemic respiratory failure. HFNT has not been extensively studied following hospitalization for an Acute Exacerbation of COPD (AECOPD). Objective We explored the feasibility of conducting a multicentered trial to evaluate the use of HFNT to increase the time to next moderate/ severe exacerbation in patients recently hospitalized for a COPD exacerbation. In this pilot study we measured the hours of home daily HFNT use, maximally tolerated flow rates and temperature, and side effects for a period of 90 days. Methods Patients were enrolled in a 90-day open-labeled pilot study of HFNT to determine the safety and feasibility of home use for daily outpatient COPD management. Patients ≥ 40 years of age with prior hospitalization within the past 12 weeks for an acute COPD exacerbation were enrolled. COPD as the primary diagnosis in all patients. Results Thirty patients presented for HFNT titration. Two dropped out; one after receiving a lung transplant and the other was lost to follow-up. The remaining 28 patients completed 90 days of HFNT. None withdrew from HFNT due to intolerance. Use of HFNT averaged 6.8 (2.1) hours daily. Conclusions Daily home HFNT for up to three months is feasible in COPD patients following hospitalization for an acute exacerbation. Improvements observed in disease specific quality of life, respiratory symptoms and 6 MWD suggest the need for a prospective multicenter controlled clinical trial.