Domiciliary high-flow treatment in patients with COPD and chronic hypoxic failure: In whom can we reduce exacerbations and hospitalizations?

Abstract

IntroductionDomiciliary High-flow, humidified, nasal cannula (HFNC) is a possible add-on in patients with chronic respiratory diseases. This post-hoc study investigates benefit of HFNC in subgroups of advanced COPD patients with chronic hypoxic failure on reduction of exacerbations and hospitalizations.MethodsOne hundred patients were randomized to HFNC in a previous trial. Subgroups with 0-1 (N = 32) respectively two or more (2+) (N = 68) exacerbations 12 months pre-study were investigated. Changes in number of exacerbations and hospitalizations pre- and in study were analyzed, corrected for HFNC days with HFNC.ResultsPatients were comparable at baseline. Exacerbations increased in subgroup 0-1 (p = 0.01) and decreased in subgroup 2+ (p = 0.03). Correcting for HFNC days no correlation was seen in subgroup 0-1 (p = 0.08), but in subgroup 2+ (pConclusionIn patients with advanced COPD, chronic hypoxic failure and two or more exacerbations per year, HFNC significantly reduced exacerbations and hospitalizations.