Value and Safety of High Flow Oxygenation in the Treatment of
Inpatient Asthma: A Randomized, Double-blind, Pilot Study
Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis
and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
This study aimed to compare the value and safety of high-flow nasal cannula (HFNC) and conventional oxygen therapy (COT) in patients with asthma exacerbation. In this randomized double blind study, forthy patients with moderate-to-severe asthma exacerbations, aged 18 years or older were enrolled. Patients were randomly assigned to receive either HFNC or COT for 24hours. Dyspnea scale, O2saturation, spirometer indexes, respiratory and heart rate, and Arterial Blood Gas (ABG) parameters were compared within2 and 24 hours of intervention.Dyspnea scale decreased significantly from ±۱٫۰۴ to 6.45±۰٫۵۱ (p=0.000), and 12% from 7.84±۱٫۷ to 6.89 ± ۰٫۹ (p=0.049) within 2 h in HFNC and COT group, . There was no difference between groups (p=0.000). In the HFNC group, FEV1 was 1.48 ±۰٫۹۴ L at the time of admission and increased to 1.61L±۰٫۶۶ and 1.82±۰٫۹۲ L after 2 and 24 h of experience, respectively, p=0.19, 0.003). Also, in COT group, FEV1 increased from 1.43±۰٫۶۵L to 1.46±۰٫۵۳L and 1.64±۰٫۶ L in the respective time-points, p=0.071, 0.079). PaO2and O2 saturation increased significantly in both groups during the first 2h. Two patients in the HFNC group had the complaint of nasal irritation or the device produced heat and one patient in the COT group needed more respiratory care. HFNC could be a therapeutic option for asthma exacerbation among adult patients, however, the patient’s selection should be considered.
Keywords: Asthma; -Oxygen Inhalation Therapy, ; Disease Exacerbation; High-flow Nasal Cannula (HFNC).