High Flow Nasal Therapy Use in Patients with Acute Exacerbation of COPD and Bronchiectasis: A Feasibility Study

The efficacy and feasibility of high flow nasal therapy (HFNT) use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and bronchiectasis is unknown. We performed a single-center, single-arm prospective observational study in patients with AECOPD, documented bronchiectasis, pH >= 7.35, respiratory rate (RR) >= 26 breaths/minute despite receiving maximal medical treatment and oxygen via face mask up to 10 L/m. Patients received HFNT (Airvo 2, Fisher & Paykel) at a gas flow of 50 L/min and FIO2 adjusted to maintain SpO(2) >= 92%. Dyspnea, rated by Borg scale, RR, arterial blood gases and mucus production (ranging from 1 to 3) were collected before and 1 h after starting HFNT and then every 24 h for 3 days. Tolerance was measured using a visual analogic scale (VAS). Fifteen patients were enrolled. After 24 h, patients showed a significant improvement in dyspnea score [Borg scale from 6.7 +/- 1.4 to 4.1 +/- 1.3 (p