![]() Breathing pattern is improved with increased V ts and decreased respiratory rate, resulting in increased alveolar ventilation and reduced neuro-ventilatory drive and work of breathing ( 5, 7). ![]() However, several physiological studies have shown beneficial effects of HFNC in hypercapnic patients, as a flow-dependent clearance of carbon dioxide of the upper airways, contributing to the reduction of anatomical dead space ventilation and carbon dioxide rebreathing ( 5, 6). Even though there is no strong evidence that long-term oxygen using conventional oxygen therapy is beneficial to reduce mortality and need for hospital admission ( 2), a new approach using high-flow nasal cannula oxygen therapy (HFNC) as long-term treatment at home could be beneficial.Īlthough HFNC is widely used in intensive care units for management of acute hypoxemic respiratory failure and is now recommended in most recent clinical practice guidelines ( 3, 4), few clinical trials have assessed HFNC for acute exacerbation of COPD or as long-term treatment at home. The natural history of chronic obstructive pulmonary disease (COPD) is characterized by recurrent exacerbations leading to lung function decline and reducing quality of life with an increased risk of early death ( 1).
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