scholarly journals Aerosol delivery aspects within a high flow therapy system in chronic obstructive pulmonary disease patients

2020 ◽  
pp. 00422-2020 ◽  
Author(s):  
Yasmin M. Madney ◽  
Nabila Ibrahim Laz ◽  
Ahmed A. Elberry ◽  
Hoda Rabea ◽  
Mohamed E.A. Abdelrahim
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Drug Delivery ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Face Mask ◽  
High Flow ◽  
Nasal Cannula ◽  
Chronic Obstructive ◽  
Aerosol Delivery ◽  
Obstructive Pulmonary Disease

There is a lack of information about the influence of patient interfaces like facemask or mouthpiece on the effective dose of aerosolized drugs while using high flow therapy in a clinical setting. These interfaces can improve pulmonary drug delivery over nasal cannula but patient preference and comfort should also be considered.The present work was to determine the effect of three different interfaces (nasal cannula, valved face mask, and mouthpiece) when combined with titrated oxygen flow on aerosol delivery in chronic obstructive pulmonary disease (COPD) patients hospitalised due to acute exacerbation.The variations between these interfaces were addressed in terms of change in lung function measurements pre-and post-inhalation, the delivered salbutamol dose, and patient tolerance to each interface.High flow nasal cannula was the most comfortable interface used. However, its pulmonary drug delivery was significantly lower than both the valved face mask and mouthpiece (p<0.05). Although drug delivery was different with the three tested interfaces, the lung function improvements were similar.

scholarly journals High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Anshul Mittal ◽  
Megha Varshney ◽  
Vidushi Rathi ◽  
Pranav Ish
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
High Flow ◽  
Nasal Cannula ◽  
Chronic Obstructive ◽  
High Flow Nasal Cannula ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Exacerbation Of Copd

High flow nasal cannula (HFNC) provides warmed and humidified air with flow rates up to 60 liters/min with relatively fixed oxygen content (FiO2). It has been extensively evaluated for hypoxemic respiratory failure and has been used in mild acute respiratory distress syndrome, pre-intubation, bronchoscopy and pediatric obstructive sleep apnea. Recent data has suggested a role in stable hypercapnic chronic obstructive pulmonary disease (COPD) and even in acute exacerbations, though, the use has not been advocated by any guidelines yet. We present a case of acute hypercapnic exacerbation of COPD, intolerant to non-invasive ventilation, showing response and improvement on use of HFNC. This case highlights this potential mechanisms and prospects for the same.

High Flow Through Nasal Cannula in Stable and Exacerbated Chronic Obstructive Pulmonary Disease Patients

2019 ◽  
Vol 14 (4) ◽  
pp. 247-260 ◽  
Author(s):  
Andrea Bruni ◽  
Eugenio Garofalo ◽  
Gianmaria Cammarota ◽  
Paolo Murabito ◽  
Marinella Astuto ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
High Flow ◽  
Nasal Cannula ◽  
Oxygen Mixture ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Hypoxemic Acute Respiratory Failure ◽  
Flow Through

Background: High-Flow through Nasal Cannula (HFNC) is a system delivering heated humidified air-oxygen mixture at a flow up to 60 L/min. Despite increasing evidence in hypoxemic acute respiratory failure, a few is currently known in chronic obstructive pulmonary disease (COPD) patients. Objective: To describe the rationale and physiologic advantages of HFNC in COPD patients, and to systematically review the literature on the use of HFNC in stable and exacerbated COPD patients, separately. Methods: A search strategy was launched on MEDLINE. Two authors separately screened all potential references. All (randomized, non-randomized and quasi-randomized) trials dealing with the use of HFNC in both stable and exacerbated COPD patients in MEDLINE have been included in the review. Results: Twenty-six studies have been included. HFNC: 1) provides heated and humidified airoxygen admixture; 2) washes out the anatomical dead space of the upper airway; 3) generates a small positive end-expiratory pressure; 4) guarantees a more stable inspired oxygen fraction, as compared to conventional oxygen therapy (COT); and 5) is more comfortable as compared to both COT and non-invasive ventilation (NIV). : In stable COPD patients, HFNC improves gas exchange, the quality of life and dyspnea with a reduced cost of muscle energy expenditure, compared to COT. In exacerbated COPD patients, HFNC may be an alternative to NIV (in case of intolerance) and to COT at extubation or NIV withdrawal. Conclusion: Though evidence of superiority still lacks and further studies are necessary, HFNC might play a role in the treatment of both stable and exacerbated COPD patients.

Sign in / Sign up

Export Citation Format

Share Document