Chronic Obstructive Pulmonary Disease (COPD) is a disease with high morbidity and mortality worldwide. COPD exacerbations are the important contributor to disease deterioration and decrease in health-related quality of life (HRQoL). Since therapeutic options to treat exacerbations effectively are limited, many patients have persistent loss of vital functioning and suffer from frequent re-hospitalisations.
Nasal high flow therapy (nHFT) is an innovative therapy that provides humidified and heated air through a nasal cannula. Although there is some preliminary evidence that nHFT is effective in stable COPD patients, there are no data at all regarding the effectiveness of nHFT in COPD exacerbations. A key problem in the implementation of nHFT is that the underlying working mechanisms are not clear and therefore the appropriate way to apply nHFT is unknown.
The aim of the study is to prove efficacy of nHFT in enhancing recovery from COPD exacerbations. We aim to improve the effectiveness of nHFT by developing new technologies to control and monitor the effect of nHFT and byproviding background for optimal settings of nHFT.
The study will be designed as a multicentre randomised controlled trial, with the University Medical Center Groningen, the “Medisch Spectrum Twente”, “Albert Schweizer ziekenhuis”, Rijnstate hospital, the University of Twente, Fisher and Paykel Healthcare ltd, and Vivisol Nederland BV collaborating.
One hundred thirty-six patients hospitalised with a COPD exacerbation will be randomised to standard care or nHFT (≥ 6 hours/day) during hospitalisation and the 90 days after discharge, as added to standard care. The primary outcome will be improvement in HRQoL after 90 days.
Once the study shows positive results, nHFT might be implemented in patient care on short-term basis. Furthermore, the study will provide a huge amount of information on the working mechanisms of nHFT and evidence-based proof for optimal settings.