COPD Exacerbation Clinical Trial
Official title:
High Flow Oxygen Therapy in Patients Suffering From Chronic Obstructive Pulmonary Disease Exacerbation: Effects and Mechanisms of Action
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with poor
outcome, especially when intubation is required, thus underlining the importance of
optimizing non-invasive ventilatory support to avoid intubation. Practically, because of
treatment intolerance, non-invasive ventilation (NIV) cannot be administered 24-hour a day
for a long period of time and alternative solutions must be found to deliver oxygen as
efficiently as possible to allow NIV interruptions. High flow humidified oxygen therapy
(HFHO) consists of delivering a high-flow (15-60 L/minute) heated air-oxygen mixture (FIO2
21-100%) through a dedicated nasal cannula and can be interesting in this context. This well
tolerated technique improves oxygenation and decreases respiratory rate and dyspnea in
patients suffering from acute hypoxemic respiratory failure. In chronic COPD patients, using
HFHO can decrease respiratory rate and PaCO2. In COPD exacerbation, using HFHO can
conceptually be interesting. First, the high air-oxygen flow delivered well matches the
patient's inspiratory demand and should decrease the work of breathing. Second, as during
HFHO a high flow is continuously delivered in the airways, a wash-out of the anatomical dead
space should occur and CO2 clearance should be enhanced. Despite this strong physiological
rational for the use of HFHO in patients suffering from COPD exacerbation, the effects of
using HFHO instead of conventional oxygenotherapy in combination with non-invasive
ventilation (NIV) in this context has never been explored.
The main objective of the study is to explore the effects of using HFHO in combination with
NIV in acute COPD exacerbation and to assess the underlying mechanisms of action.
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