Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Bräunlich, Jens, Köhler, Marcus, Wirtz, Hubert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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
_version_ 1785111822146207744
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
work_keys_str_mv AT braunlichjens nasalhighflownhfimprovesventilationinpatientswithinterstitiallungdiseaseildaphysiologicalstudy
AT kohlermarcus nasalhighflownhfimprovesventilationinpatientswithinterstitiallungdiseaseildaphysiologicalstudy
AT wirtzhubert nasalhighflownhfimprovesventilationinpatientswithinterstitiallungdiseaseildaphysiologicalstudy