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Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study
Introduction: Acute hypercapnic respiratory failure has a poor prognosis in patients with interstitial lung disease (ILD). Recent data demonstrated a positive effect of nasal high-flow (NHF) in patients with acute hypoxemic respiratory failure. Preliminary data also show benefits in several hypercap...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531871/ https://www.ncbi.nlm.nih.gov/pubmed/37762795 http://dx.doi.org/10.3390/jcm12185853 |
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author | Bräunlich, Jens Köhler, Marcus Wirtz, Hubert |
author_facet | Bräunlich, Jens Köhler, Marcus Wirtz, Hubert |
author_sort | Bräunlich, Jens |
collection | PubMed |
description | Introduction: Acute hypercapnic respiratory failure has a poor prognosis in patients with interstitial lung disease (ILD). Recent data demonstrated a positive effect of nasal high-flow (NHF) in patients with acute hypoxemic respiratory failure. Preliminary data also show benefits in several hypercapnic chronic lung diseases. Objectives: The aim of this study was to characterize flow-dependent changes in mean airway pressure, breathing volumes, and breathing frequency and decreases in PCO(2). Methods: Mean airway pressure was measured in the nasopharyngeal space. To evaluate breathing volumes, a polysomnographic device was used (16 patients). All subjects received 20, 30, 40, and 50 L/min and—to illustrate the effects—nCPAP and nBiPAP. Capillary blood gas analyses were performed in 25 hypercapnic ILD subjects before and 5 h after the use of NHF. Additionally, comfort and dyspnea during the use of NHF were surveyed. Results: NHF resulted in a small flow-dependent increase in mean airway pressure. Tidal volume was unchanged and breathing rate decreased. The calculated minute volume decreased by 20 and 30 L/min NHF breathing. In spite of this fact, hypercapnia decreased at a flow rate of 24 L/min. Additionally, an improvement in dyspnea was observed. Conclusions: NHF leads to a reduction in paCO(2). This is most likely achieved by a washout of the respiratory tract and a reduction in functional dead space. NHF enhances the effectiveness of breathing in ILD patients by the reduction in respiratory rate. In summary, NHF works as an effective ventilatory support device in hypercapnic ILD patients. |
format | Online Article Text |
id | pubmed-10531871 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-105318712023-09-28 Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study Bräunlich, Jens Köhler, Marcus Wirtz, Hubert J Clin Med Article Introduction: Acute hypercapnic respiratory failure has a poor prognosis in patients with interstitial lung disease (ILD). Recent data demonstrated a positive effect of nasal high-flow (NHF) in patients with acute hypoxemic respiratory failure. Preliminary data also show benefits in several hypercapnic chronic lung diseases. Objectives: The aim of this study was to characterize flow-dependent changes in mean airway pressure, breathing volumes, and breathing frequency and decreases in PCO(2). Methods: Mean airway pressure was measured in the nasopharyngeal space. To evaluate breathing volumes, a polysomnographic device was used (16 patients). All subjects received 20, 30, 40, and 50 L/min and—to illustrate the effects—nCPAP and nBiPAP. Capillary blood gas analyses were performed in 25 hypercapnic ILD subjects before and 5 h after the use of NHF. Additionally, comfort and dyspnea during the use of NHF were surveyed. Results: NHF resulted in a small flow-dependent increase in mean airway pressure. Tidal volume was unchanged and breathing rate decreased. The calculated minute volume decreased by 20 and 30 L/min NHF breathing. In spite of this fact, hypercapnia decreased at a flow rate of 24 L/min. Additionally, an improvement in dyspnea was observed. Conclusions: NHF leads to a reduction in paCO(2). This is most likely achieved by a washout of the respiratory tract and a reduction in functional dead space. NHF enhances the effectiveness of breathing in ILD patients by the reduction in respiratory rate. In summary, NHF works as an effective ventilatory support device in hypercapnic ILD patients. MDPI 2023-09-08 /pmc/articles/PMC10531871/ /pubmed/37762795 http://dx.doi.org/10.3390/jcm12185853 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bräunlich, Jens Köhler, Marcus Wirtz, Hubert Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study |
title | Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study |
title_full | Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study |
title_fullStr | Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study |
title_full_unstemmed | Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study |
title_short | Nasal High-Flow (NHF) Improves Ventilation in Patients with Interstitial Lung Disease (ILD)—A Physiological Study |
title_sort | nasal high-flow (nhf) improves ventilation in patients with interstitial lung disease (ild)—a physiological study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531871/ https://www.ncbi.nlm.nih.gov/pubmed/37762795 http://dx.doi.org/10.3390/jcm12185853 |
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