scholarly journals Bronchodilator Delivery via High-Flow Nasal Cannula: A Randomized Controlled Trial to Compare the Effects of Gas Flows

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1655
Author(s):  
Jie Li ◽  
Yibing Chen ◽  
Stephan Ehrmann ◽  
Jie Wu ◽  
Lixin Xie ◽  
...  

(1) Background: Aerosol delivery via high-flow nasal cannula (HFNC) has attracted increasing clinical interest. In vitro studies report that the ratio of HFNC gas flow to patient inspiratory flow (GF:IF) is a key factor in the efficiency of trans-nasal aerosol delivery. (2) Methods: In a randomized controlled trial, patients with a history of COPD or asthma and documented positive responses to inhaled bronchodilators in an outpatient pulmonary function laboratory were recruited. Subjects were randomized to receive inhalation at gas flow ratio settings of: GF:IF = 0.5, GF:IF = 1.0, or GF = 50 L/min. Subjects were assigned to inhale saline (control) followed by salbutamol via HFNC with cumulative doses of 0.5 mg, 1.5 mg, 3.5 mg, and 7.5 mg. Spirometry was performed at baseline and 10–12 min after each inhalation. (3) Results: 75 subjects (49 asthma and 26 COPD) demonstrating bronchodilator response were enrolled. Per the robust ATS/ERS criteria no difference was observed between flows, however using the criteria of post-bronchodilator forced expiratory volume in the first second (FEV1) reaching the screening post-bronchodilator FEV1 with salbutamol, a higher percentage of subjects receiving GF:IF = 0.5 met the criteria at a cumulative dose of 1.5 mg than those receiving GF:IF = 1.0, and GF = 50 L/min (64% vs. 29% vs. 27%, respectively, p = 0.011). Similarly at 3.5 mg (88% vs. 54% vs. 46%, respectively, p = 0.005). The effective dose at GF:IF = 0.5 was 1.5 mg while for GF = 50 L/min it was 3.5 mg. (4) Conclusions: During salbutamol delivery via HFNC, cumulative doses of 1.5 mg to 3.5 mg resulted in effective bronchodilation. Applying the robust ATS/ERS criteria no difference was observed between the flows, however using the more sensitive criteria of subjects reaching post screening FEV1 to salbutamol via HFNC, a higher number of subjects responded to the doses of 0.5 mg and 1.5 mg when HFNC gas flow was set at 50% of patient peak inspiratory flow.

2020 ◽  
Author(s):  
Jie Li ◽  
Yibing Chen ◽  
Stephan Ehrmann ◽  
Jie Wu ◽  
Lixin Xie ◽  
...  

Abstract BackgroundAerosol delivery via high-flow nasal cannula (HFNC) has attracted increasing clinician interest. In vitro studies report that the ratio of HFNC gas flow to patient inspiratory flow (GF:IF) is a key factor in the efficiency of trans-nasal aerosol delivery. This randomized controlled trial was aimed to validate this finding, and to explore the effective dose of inhaled bronchodilator to be given to patients via HFNC. Methods Patients with a history of COPD or asthma and documented positive response to inhaled bronchodilators in an outpatient pulmonary function laboratory were recruited. Subjects were randomized to receive inhalation at gas flow ratio/settings of : GF:IF=0.5, GF:IF=1.0, or GF=50L/min. Patients were assigned to inhale saline (control) followed by salbutamol via HFNC with an escalating dose sequence (0.5mg, 1.0mg, 2.0mg and 4.0mg). Spirometry was performed at baseline and after each inhalation. Results Seventy-five subjects (49 asthma and 26 COPD) demonstrating bronchodilator response (ATS/ERS) were enrolled. Using the criteria of post-bronchodilator FEV1 returning to screening post-bronchodilator FEV1 with salbutamol, a higher percentage of subjects receiving GF:IF=0.5 met criteria at cumulative dose of 1.5mg, than those receiving GF:IF=1.0, and GF=50L/min (64% vs 29% vs 27%, respectively, p=0.011). Similarly at 3.5mg (88% vs 54% vs 46%, respectively, p=0.005). The effective dose at GF:IF=0.5 was 1.5mg while for GF=50 L/min it was 3.5mg. Conclusion Dose response to salbutamol via HFNC was greater when administered with gas flow set at 50% of patient inspiratory flow, than with higher gas flow rates. Trial registration: www.clinicaltrials.gov: NCT03739359. Registered 13 November 2018, https://clinicaltrials.gov/ct2/show/NCT03739359?term=03739359&draw=2&rank=1


Author(s):  
Veronica Rossi ◽  
Serena Cirio ◽  
Manuela Piran ◽  
Giuditta Bettinelli ◽  
Laura Zocchi ◽  
...  

2018 ◽  
Vol 46 (1) ◽  
pp. 553-553
Author(s):  
Regina Cesar ◽  
Bibiane Bispo ◽  
Priscila Helena Felix ◽  
Maria carolina Modolo ◽  
Soraia Cabó ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document