High Flow Nasal Cannula for COPD
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores how well a high flow nasal cannula (HFNC) clears sputum (phlegm) in people experiencing a COPD flare-up (a chronic lung disease). The HFNC device delivers warm, humidified oxygen at a flow rate that may reduce cough and potentially avoid more intense treatments. Participants will use either the HFNC or standard oxygen therapy to determine which is more effective in easing symptoms. The trial seeks individuals admitted to the hospital with a COPD flare-up who have increased sputum or difficulty clearing it. As an unphased trial, it offers participants the chance to contribute to important research that could improve COPD management.
Do I need to stop my current medications for this trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that the high flow nasal cannula is safe for COPD patients?
Research has shown that High Flow Nasal Cannula (HFNC) therapy is generally safe for people with COPD, a lung disease that makes breathing difficult. Studies have found HFNC to be about as safe as noninvasive ventilation (NIV), a common treatment for breathing issues.
One study found that HFNC reduced the need for a breathing tube, indicating its safety. Another study showed that HFNC therapy led to fewer hospital visits and shorter stays over a year for people with severe COPD, suggesting it is well-tolerated over time.
Overall, current research considers HFNC safe, with no major safety concerns reported. However, individual experiences can differ, so discussing any treatment with a healthcare provider is always important.12345Why are researchers excited about this trial?
Most treatments for COPD rely on standard oxygen therapy, which provides oxygen at lower flow rates and without humidity. The High Flow Nasal Cannula (HFNC) is unique because it delivers oxygen at a much higher flow rate, up to 50L/min, with heated and humidified air. This method can improve patient comfort and may enhance oxygenation more effectively. Researchers are excited about HFNC because it could offer a more comfortable and potentially more efficient alternative to conventional oxygen therapy, especially for patients who struggle with the typical low-flow systems.
What evidence suggests that high flow nasal cannula is effective for sputum clearance in COPD?
Research has shown that high flow nasal cannula (HFNC), which participants in this trial may receive, can assist individuals with COPD, a lung disease that makes breathing difficult. Studies have found that HFNC reduces the need for intubation, where a tube assists with breathing, and enhances patient comfort during treatment. HFNC also lowers carbon dioxide levels in the blood, crucial for COPD patients who struggle to expel this gas. By providing warm, moist air at a high flow rate, it eases breathing and may help clear mucus from the throat. Overall, HFNC is as effective as other more complex machines in managing breathing problems in people with COPD.16789
Who Is on the Research Team?
Nicholas S Hill, MD
Principal Investigator
Tufts Medical Center
Are You a Good Fit for This Trial?
This trial is for adults over 18 hospitalized with a worsening of COPD symptoms, like more coughing or changes in sputum. They must have known COPD or a high chance of it based on their doctor's assessment and tests. People can't join if they're bleeding heavily from the lungs, can't follow the study plan, are in other overlapping studies, can't consent, are very unconscious or in shock, need breathing support machines right away, have weak coughs due to muscle issues, face injuries that prevent wearing nasal cannula properly, have certain lung conditions like bronchiectasis or cystic fibrosis, or aren’t expected to survive their hospital stay.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomized to receive either high flow nasal cannula (HFNC) or conventional flow nasal oxygen (CFNO) for 24 hours
Follow-up
Participants are monitored for changes in sputum clearability and wettability, as well as cough severity and frequency
Post-treatment observation
Participants are observed for any need for escalation of care, including non-invasive ventilation or transfer to higher level of care
What Are the Treatments Tested in This Trial?
Interventions
- High Flow Nasal Cannula
Trial Overview
The study is testing if High Flow Nasal Cannula (HFNC), which gives warm and humid oxygen at high speeds up to 60L/min helps clear out phlegm better during severe COPD flare-ups compared to standard oxygen therapy. It also looks at whether HFNC affects how bad patients' coughs feel and if it reduces the need for more intense treatments.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
The HFNC group will receive heated (approximately 37 ⁰C) and humidified (100% relative humidity) oxygenated gas delivered at high flow at 50L/min. Flow could be decreased to as low as 30L/min and temperature to 31 ⁰C as per patient's tolerance.
The conventional flow nasal oxygen (CFNO) group is the control group which will receive ambient temperature and non-humidified oxygen delivered at flow rates of up to 8L/min (standard care).
Find a Clinic Near You
Who Is Running the Clinical Trial?
Tufts Medical Center
Lead Sponsor
Virginia Commonwealth University
Collaborator
Citations
Comparison of clinical outcomes between high-flow nasal ...
High-flow nasal cannula (HFNC) has recently emerged as a promising alternative to non-invasive ventilation (NIV) for patients with chronic ...
Effects of high-flow nasal cannula oxygen therapy for ...
HFNC has a good therapeutic effect in patients with AECOPD and type II respiratory failure. It improves patient comfort and has clinical value.
The use of high-flow nasal cannula in patients with chronic ...
We found that HFNC was non-inferior to NIV in reducing the risk of intubation and reintubation for patients with COPD exacerbation.
High flow nasal cannula oxygen therapy versus non-invasive ...
Effect of high-flow nasal cannula oxygen on patients with chronic obstructive pulmonary disease and mild hypercapnia: a retrospective cohort ...
World Academy of Sciences Journal
Evaluation of the effectiveness and factors associated with the treatment outcomes of high‑flow nasal cannula and bilevel positive airway ...
A high-flow nasal cannula versus noninvasive ventilation in ...
We investigated the efficacy and safety of a high-flow nasal cannula (HFNC) at different flow rates compared to noninvasive ventilation (NIV) in patients with ...
The efficacy and safety of high-flow nasal cannula therapy in ...
We aimed to evaluate the efficacy and safety of HFNC therapy in patients with COPD and type II respiratory failure, to provide evidence to the clinical COPD ...
The use of high-flow nasal cannula in patients with chronic ...
We found that HFNC was non-inferior to NIV in reducing the risk of intubation and reintubation for patients with COPD exacerbation.
The Effects of Home High-Flow Nasal Cannula Oxygen ...
One-year-long HFNC therapy significantly decreased the COPD exacerbations rate, hospital admissions, and in-hospital days in severe COPD patients.
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