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High-Flow Oxygen Therapy (HFOT) during training in COPD with chronic respiratory failure (CRF): a multicentre randomized controlled trial

Michele Vitacca, Mara Paneroni, Elisabetta Zampogna, Antonio Spanevello, Piero Ceriana, Annalisa Carlucci, Paolo Banfi, Gabriele Pappacoda, Ludovico Trianni, Antonio Brogneri, Stefano Belli, Elena Paracchini, Maria Aliani, Vito Spinelli, Francesco Gigliotti, Barbara Lanini, Marta Lazzeri, Enrico Clini, Nicolino Ambrosino
European Respiratory Journal 2019 54: RCT449; DOI: 10.1183/13993003.congress-2019.RCT449
Michele Vitacca
1Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Italy
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  • For correspondence: michele.vitacca@icsmaugeri.it
Mara Paneroni
1Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Italy
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Elisabetta Zampogna
2Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
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Antonio Spanevello
2Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
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Piero Ceriana
3Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Annalisa Carlucci
3Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Paolo Banfi
4Istituto Don Gnocchi, Milano, Italy
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Gabriele Pappacoda
4Istituto Don Gnocchi, Milano, Italy
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Ludovico Trianni
5Villa Pineta, Gaiato, Italy
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Antonio Brogneri
5Villa Pineta, Gaiato, Italy
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Stefano Belli
6Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Italy
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Elena Paracchini
6Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Italy
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Maria Aliani
7Istituti Clinici Scientifici Maugeri IRCCS, Cassano delle Murge, Italy
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Vito Spinelli
7Istituti Clinici Scientifici Maugeri IRCCS, Cassano delle Murge, Italy
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Francesco Gigliotti
8Istituto Don Gnocchi, Firenze, Italy
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Barbara Lanini
8Istituto Don Gnocchi, Firenze, Italy
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Marta Lazzeri
9Ospedale Niguarda, Milano, Italy
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Enrico Clini
10Università degli Studi Modena e Reggio Emilia, Modena, Italy
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Nicolino Ambrosino
11Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
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Abstract

We compared in COPD with CRF undergoing training, HFOT (AIRVO2® Fisher&Paykel, (Flow/Temperature ranged 20-60 l/min/30-37°C respectively) vs oxygen Venturi Mask (V-mask) at iso-FiO2 on improving exercise tolerance.

171 patients were allocated to two groups; all used the same high-intensity exercise program (1 session/day for ≥ 20 sessions) with different oxygen device. BMI, spirometry and co morbidities have been collected. Baseline and after training exercise tolerance (Constant Work Rate Exercise Test, CWERT + 6-min walk test, 6MWT), respiratory (MIP/MEP) and biceps/quadriceps muscle strength, blood gases, Barthel Index and Barthel Dyspnoea Index, CAT and MRF-26 were measured. Patients’ satisfaction has been evaluated.

71 and 66 patients were analysed for HFOT and V-mask respectively being 15% and 24% the rate of drop-out. All variables improved after training in both groups with similar satisfaction. Comparing the two groups, only meters at 6MWT resulted statistically higher in HFOT group (p=0.029). HFOT group performed 153 seconds more than V-mask at CWERT, without statistical significance (p=0.057). Improvers (gain > 150 sec at CWERT) were 44% and 56% for V-mask and HFOT, respectively. FEV1% prd higher than 30% (OR 2.44, p=0.025) and higher baseline endurance time (OR 1.15, p=0.024) predicted improvers. Low BMI (OR 0.9298, p=0.038) predicted drop-outs. CWERT improvement was positively related to comorbidities (p=0.025) and CAT (p=0.031), while negatively to PaO2/FiO2 (p=0.04).

We have confirmed the strong indication to training program in advanced COPD with CRF; HFOT used during training may further increase exercise tolerance.

  • COPD - management
  • Oxygen therapy
  • Physiotherapy care

Footnotes

Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, RCT449.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2019
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High-Flow Oxygen Therapy (HFOT) during training in COPD with chronic respiratory failure (CRF): a multicentre randomized controlled trial
Michele Vitacca, Mara Paneroni, Elisabetta Zampogna, Antonio Spanevello, Piero Ceriana, Annalisa Carlucci, Paolo Banfi, Gabriele Pappacoda, Ludovico Trianni, Antonio Brogneri, Stefano Belli, Elena Paracchini, Maria Aliani, Vito Spinelli, Francesco Gigliotti, Barbara Lanini, Marta Lazzeri, Enrico Clini, Nicolino Ambrosino
European Respiratory Journal Sep 2019, 54 (suppl 63) RCT449; DOI: 10.1183/13993003.congress-2019.RCT449

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High-Flow Oxygen Therapy (HFOT) during training in COPD with chronic respiratory failure (CRF): a multicentre randomized controlled trial
Michele Vitacca, Mara Paneroni, Elisabetta Zampogna, Antonio Spanevello, Piero Ceriana, Annalisa Carlucci, Paolo Banfi, Gabriele Pappacoda, Ludovico Trianni, Antonio Brogneri, Stefano Belli, Elena Paracchini, Maria Aliani, Vito Spinelli, Francesco Gigliotti, Barbara Lanini, Marta Lazzeri, Enrico Clini, Nicolino Ambrosino
European Respiratory Journal Sep 2019, 54 (suppl 63) RCT449; DOI: 10.1183/13993003.congress-2019.RCT449
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