High Flow Nasal Cannula During Pulmonary Rehabilitation
Condition: Chronic Obstructive Pulmonary Disease
MeSH terms: Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
Study type: Interventional

Summary: 
      The primary purpose of this study is to compare and assess the immediate and long-term
      effects on pulmonary rehabilitation training with the usage of HFNC or conventional oxygen
      therapy device.

      The hypotheses was, with high flow nasal cannula usage while exercising, the physiological
      outcome measurements would be better than conventional oxygen therapy device. Also, the usage
      of HFNC can immediately increase patient's exercising endurance and decrease dyspnea caused
      by exercising.
    

Detailed description: 
      Pulmonary Rehabilitation is one of the most recommended methods to improve the muscle
      function of COPD patients. By exercise training, even patients with severe COPD can increase
      muscle strength, improve skeletal muscle function and enhance exercise endurance. Due to
      improvements in exercise endurance, when exercising at a higher intensity, ventilation
      support and dynamic hyperinflation would slightly decrease which leads to less dyspnea during
      exercise. Continuously exercising can also increase the motivation to exercise, reduce mood
      irritability and psychological burden caused by symptoms. By exercising, patient's health
      status can be both improved physically and mentally.

      High Flow Nasal Cannula (HFNC) is a non-invasive ventilatory device that provides stable
      oxygen concentration, temperature (37℃) and humidity (Relative Humidity: 100%). Humidity
      provided by the HFNC reduces irritation caused by the high flow, which leads to the increase
      of user's tolerance with the device. With the half-closed system formed by a nasal prong,
      when the high flow enters the upper airway, continue positive airway pressure would be
      formed.

      Subjects enrolled into this study are required to join a 6-week pulmonary rehabilitation
      program. Before starting the program, subjects were randomly assigned to high flow nasal
      cannula group and conventional oxygen therapy group. When exercising, the nasal cannula group
      would receive an oxygen flow of 3 - 5L to maintain SpO2>90% and the HFNC group with high flow
      setting of 45-50Lpm along with oxygen flow of 3-5L also to maintain SpO2>90%. When joining
      the pulmonary rehabilitation program, patients are required to exercise for approximately 45
      minutes per session. When exercising, changes in the degree of dyspnea, quadriceps blood flow
      and hemodynamics are assessed. After 6-week of the exercise training, all the parameters will
      again be assessed and compared to the primary data that was collected from the beginning of
      the program.
    

Intervention name(s): High Flow Nasal Cannula; Nasal Cannula
Intervention type(s): Device; Device
Intervention description(s): High Flow Nasal Cannula (HFNC) is an oxygen device that increases oxygenation and washes out CO2 within the dead space, it was also clinically used to correct hypoxemia, hypercapnia and respiratory failure.By providing flow rate that is similar to or higher than the patient's inspiratory flow, HFNC is able to provide ventilatory support. To produce stable oxygen concentration, HFNC entrains less air in order to reach the preset value.; Nasal cannula is an oxygen therapy device that has been commonly used as treatment for patients with hypoxemia. With the adjustable flow of 1-6Lpm, the concentration of the oxygen differs as the breathing pattern of the patient changes.
Other intervention name(s): HFNC
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: High flow nasal cannula; Pulmonary rehab; Pulmonary rehabilitation; Nasal cannula; Exercise endurance; Oxygen Therapy; COPD; Chronic Obstructive Pulmonary Disease