B14-07 Home High-flow Therapy for Stable and Severe Bronchiectasis Patients: A Multicenter Randomized Crossover Trial (flobe)
R Hirabayashi, K Nagata, Y Chihara, T Asakura, T Kawano, T Tsuda, Y Mori, T Kitajima, H Matsumoto, T Kadowaki, N Hamao, M Ito, K Morimoto, T Kato, R Kagami, H Morishita, T Matsuki, A Yoshida, N Kato, K TomiiAbstract
Introduction and Rationale
Home high-flow nasal cannula therapy may improve symptoms and chronic respiratory failure in severe bronchiectasis, but its clinical benefit remains unclear. The objective of this study is to evaluate the efficacy and safety of home high-flow nasal cannula therapy in patients with severe bronchiectasis.
Method
We conducted a multicenter, randomized crossover trial comparing high-flow nasal cannula therapy plus usual care with usual care alone in thirty-one adults with clinically stable, severe bronchiectasis and chronic respiratory insufficiency as defined in the protocol. Participants received either six weeks of home high-flow nasal cannula therapy plus usual care followed by six weeks of usual care alone, or the reverse sequence. The primary outcome was the change in the St. George’s Respiratory Questionnaire total score. Treatment, period, and allocation effects were assessed using linear mixed-effects models. Twenty-seven patients were included in the analysis.
Results
High-flow nasal cannula therapy significantly improved the mean St. George’s Respiratory Questionnaire total score compared with usual care alone (4.4 points; 95% confidence interval, 0.9 to 8.0; P = 0.02). High-Flow Nasal Cannula therapy also improved pressure of arterial carbon dioxide (adjusted treatment effect, −3.5 Torr; 95% confidence interval, −6.0 to − 1.0 Torr) and pH (adjusted treatment effect, +0.02; 95% confidence interval, 0.01 to 0.03). No significant effects were observed for pulmonary function, 6-minute walk test, or imaging findings. No safety concerns were identified.
Conclusion
Six weeks treatment of home high-flow nasal cannula therapy improved health-related quality of life and hypercapnia in patients with severe bronchiectasis.
Clinical trial registered with https://jrct.mhlw.go.jp/latest-detail/jRCT1052230157 (jRCT1052230157)
This abstract is funded by: Teijin Pharma