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UK feasibility randomised controlled trial on home HFT

Dr. Rebecca D’Cruz, leading the ongoing UK feasibility study on home high-flow therapy (HFT), gives her talk about the practice of this therapy in COPD and discusses what the future might hold for the growing field of home HFT.
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Key facts

  • JIVD CONGRESS 2022
  • WITH DR REBECCA D'CRUZ
  • HFT TODAY: NEW CLINICAL RESEARCH AND PRACTICE

Content

Dr. Rebecca D’Cruz discusses insights relating to the evidence and practice regarding the use of home high-flow therapy (HFT) in chronic obstructive pulmonary disease (COPD) from her ongoing feasibility randomised controlled trial.

Our guest gives a detailed overview of COPD pathophysiology as well as outlining the ways in which home HFT may assist COPD patients including mucociliary clearance1-2, dead space washout3, and improved pulmonary mechanics4-6.

She also highlights an important problem to address: 20 to 25% of COPD patients who are hospitalised with a COPD exacerbation are readmitted within 30 days of discharge and each exacerbation has a huge impact on them.

So, putting theories into practice, the research question for her feasibility randomised controlled trial was: ‘Can the use of home high-flow therapy improve clinical, patient-reported and physiological outcomes in patients recovering from severe COPD exacerbation, that require hospitalisation?’

Dr. D’Cruz presents the details and explains the process behind the feasibility study, describes previous research showing the potential benefits of home HFT in chronic respiratory failure7-8, and shows where her study sits with the established literature. The qualitative research of patient and family interviews is also highlighted before Dr. D’Cruz concludes with the future of home HFT in COPD.

With HFT still a relatively novel therapy for COPD, further research in the area is certainly necessary going forward. To hear more insights into Dr. D’Cruz’s current research in the field, simply register to watch the full webinar.

Speakers

Dr Rebecca D'Cruz

Royal Free London NHS Foundation Trust, UK

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1. Williams, Robin PhD; Rankin, Nigel MB, BS, FFARACS; Smith, Tony MB, ChB, FFICANZCA; Galler, David MB, ChB, FFICANZCA; Seakins, Paul BE. Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Critical Care Medicine: November 1996 – Volume 24 – Issue 11 – p 1920-1929.

2. Hasani A, Chapman T, McCool D, Smith R, Dilworth J, Agnew J. Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis. Chronic Respiratory Disease. 2008;5(2):81-86. doi:10.1177/1479972307087190.

3. Winfried Möller, Gülnaz Celik, Sheng Feng, Peter Bartenstein, Gabriele Meyer, Oliver Eickelberg, Otmar Schmid, and Stanislav Tatkov. Nasal high flow clears anatomical dead space in upper airway models. Journal of Applied Physiology 2015 118:12, 1525-1532.

4. R. Parke, S. McGuinness, M. Eccleston. Nasal high-flow therapy delivers low level positive airway pressure. British Journal of Anaesthesia, Volume 103, Issue 6, 2009, Pages 886-890, ISSN 0007-0912, https://doi.org/10.1093/bja/aep280.

5. Bräunlich J, Köhler M, Wirtz H. Nasal highflow improves ventilation in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2016;11(1):1077-1085 https://doi.org/10.2147/COPD.S104616.

6. Pisani L, Fasano L, Corcione N, et al. Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnic COPD. Thorax 2017;72:373-5. 10.1136/thoraxjnl-2016-209673.

7. Line Hust Storgaard, Ulla Møller Weinreich & Birgitte Schantz Laursen (2020) COPD Patients’ Experience of Long-Term Domestic Oxygen-Enriched Nasal High Flow Treatment: A Qualitative Study, COPD: Journal of Chronic Obstructive Pulmonary Disease, 17:2, 175-183, DOI: 10.1080/15412555.2020.1736998

8. Bräunlich J, Dellweg D, Bastian A, Budweiser S, Randerath W, Triché D, Bachmann M, Kähler C, Bayarassou AH, Mäder I, Geiseler J, Köhler N, Petroff D, Wirtz H. Nasal high-flow versus noninvasive ventilation in patients with chronic hypercapnic COPD. Int J Chron Obstruct Pulmon Dis. 2019;14:1411-1421. https://doi.org/10.2147/COPD.S206111.