Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial
Abstract Background Supplemental oxygen delivered with standard oxygen therapy (SOT) improves exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Although high-flow nasal cannula oxygen therapy (HFNC) improves oxygenation in other respiratory diseases, its impact on exercise perf...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-021-01727-9 |
| _version_ | 1819006613777809408 |
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| author | Diana Badenes-Bonet Pilar Cejudo Anna Rodó-Pin Clara Martín-Ontiyuelo Roberto Chalela Jose Antonio Rodríguez-Portal Rosa Vázquez-Sánchez Joaquim Gea Xavier Duran Oswaldo Antonio Caguana Diego Agustín Rodriguez-Chiaradia Eva Balcells |
| author_facet | Diana Badenes-Bonet Pilar Cejudo Anna Rodó-Pin Clara Martín-Ontiyuelo Roberto Chalela Jose Antonio Rodríguez-Portal Rosa Vázquez-Sánchez Joaquim Gea Xavier Duran Oswaldo Antonio Caguana Diego Agustín Rodriguez-Chiaradia Eva Balcells |
| author_sort | Diana Badenes-Bonet |
| collection | DOAJ |
| description | Abstract Background Supplemental oxygen delivered with standard oxygen therapy (SOT) improves exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Although high-flow nasal cannula oxygen therapy (HFNC) improves oxygenation in other respiratory diseases, its impact on exercise performance has never been evaluated in IPF patients. We hypothesized that HFNC may improve exercise capacity in IPF subjects compared to SOT. Methods This was a prospective, crossover, pilot randomized trial that compared both oxygenation methods during a constant submaximal cardiopulmonary exercise test (CPET) in IPF patients with exertional oxygen saturation (SpO2) ≤ 85% in the 6-min walking test. The primary outcome was endurance time (Tlim). Secondary outcomes were muscle oxygen saturation (StO2) and respiratory and leg symptoms. Results Ten IPF patients [71.7 (6) years old, 90% males] were included. FVC and DLCO were 58 ± 11% and 31 ± 13% pred. respectively. Tlim during CPET was significantly greater using HFNC compared to SOT [494 ± 173 vs. 381 ± 137 s, p = 0.01]. HFNC also associated with a higher increase in inspiratory capacity (IC) [19.4 ± 14.2 vs. 7.1 ± 8.9%, respectively; p = 0.04], and a similar trend was observed in StO2 during exercise. No differences were found in respiratory or leg symptoms between the two oxygen devices. Conclusions This is the first study demonstrating that HFNC oxygen therapy improves exercise tolerance better than SOT in IPF patients with exertional desaturation. This might be explained by changes in ventilatory mechanics and muscle oxygenation. Further and larger studies are needed to confirm the benefits of HFNC in IPF patients and its potential usefulness in rehabilitation programs. |
| first_indexed | 2024-12-21T00:11:28Z |
| format | Article |
| id | doaj.art-e951b5575056477e81e043b7fbaa2ff2 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-21T00:11:28Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-e951b5575056477e81e043b7fbaa2ff22022-12-21T19:22:20ZengBMCBMC Pulmonary Medicine1471-24662021-11-012111910.1186/s12890-021-01727-9Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trialDiana Badenes-Bonet0Pilar Cejudo1Anna Rodó-Pin2Clara Martín-Ontiyuelo3Roberto Chalela4Jose Antonio Rodríguez-Portal5Rosa Vázquez-Sánchez6Joaquim Gea7Xavier Duran8Oswaldo Antonio Caguana9Diego Agustín Rodriguez-Chiaradia10Eva Balcells11Respiratory Department, Servei de Pneumologia, Hospital del MarGrupo CB17/06/00030, Centro de Investigación en Red de Enfermedades Respiratorias, (CIBERES), Instituto de Salud Carlos III (ISCIII)Respiratory Department, Servei de Pneumologia, Hospital del MarRespiratory Department, Servei de Pneumologia, Hospital del MarRespiratory Department, Servei de Pneumologia, Hospital del MarGrupo CB17/06/00030, Centro de Investigación en Red de Enfermedades Respiratorias, (CIBERES), Instituto de Salud Carlos III (ISCIII)Unidad Médico-Quirúrgica de Enfermedades Respiratorias, University Hospital Virgen del RocíoRespiratory Department, Servei de Pneumologia, Hospital del MarScientific, Statistics and Technical Department, Hospital del Mar-IMIMRespiratory Department, Servei de Pneumologia, Hospital del MarRespiratory Department, Servei de Pneumologia, Hospital del MarRespiratory Department, Servei de Pneumologia, Hospital del MarAbstract Background Supplemental oxygen delivered with standard oxygen therapy (SOT) improves exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Although high-flow nasal cannula oxygen therapy (HFNC) improves oxygenation in other respiratory diseases, its impact on exercise performance has never been evaluated in IPF patients. We hypothesized that HFNC may improve exercise capacity in IPF subjects compared to SOT. Methods This was a prospective, crossover, pilot randomized trial that compared both oxygenation methods during a constant submaximal cardiopulmonary exercise test (CPET) in IPF patients with exertional oxygen saturation (SpO2) ≤ 85% in the 6-min walking test. The primary outcome was endurance time (Tlim). Secondary outcomes were muscle oxygen saturation (StO2) and respiratory and leg symptoms. Results Ten IPF patients [71.7 (6) years old, 90% males] were included. FVC and DLCO were 58 ± 11% and 31 ± 13% pred. respectively. Tlim during CPET was significantly greater using HFNC compared to SOT [494 ± 173 vs. 381 ± 137 s, p = 0.01]. HFNC also associated with a higher increase in inspiratory capacity (IC) [19.4 ± 14.2 vs. 7.1 ± 8.9%, respectively; p = 0.04], and a similar trend was observed in StO2 during exercise. No differences were found in respiratory or leg symptoms between the two oxygen devices. Conclusions This is the first study demonstrating that HFNC oxygen therapy improves exercise tolerance better than SOT in IPF patients with exertional desaturation. This might be explained by changes in ventilatory mechanics and muscle oxygenation. Further and larger studies are needed to confirm the benefits of HFNC in IPF patients and its potential usefulness in rehabilitation programs.https://doi.org/10.1186/s12890-021-01727-9Idiopathic pulmonary fibrosisHigh-flow nasal cannulaOxygen therapyExertional desaturation |
| spellingShingle | Diana Badenes-Bonet Pilar Cejudo Anna Rodó-Pin Clara Martín-Ontiyuelo Roberto Chalela Jose Antonio Rodríguez-Portal Rosa Vázquez-Sánchez Joaquim Gea Xavier Duran Oswaldo Antonio Caguana Diego Agustín Rodriguez-Chiaradia Eva Balcells Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial BMC Pulmonary Medicine Idiopathic pulmonary fibrosis High-flow nasal cannula Oxygen therapy Exertional desaturation |
| title | Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial |
| title_full | Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial |
| title_fullStr | Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial |
| title_full_unstemmed | Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial |
| title_short | Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial |
| title_sort | impact of high flow oxygen therapy during exercise in idiopathic pulmonary fibrosis a pilot crossover clinical trial |
| topic | Idiopathic pulmonary fibrosis High-flow nasal cannula Oxygen therapy Exertional desaturation |
| url | https://doi.org/10.1186/s12890-021-01727-9 |
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