High Flow Nasal Oxygen For Hypercapnic, Acidotic Exacerbation Chronic Obstructive Pulmonary Disease

What this Trial Is About

Researchers are investigating the use of High Flow Nasal Oxygen (HFNO) compared to the standard treatment Non-Invasive Ventilation (NIV) for patients experiencing acute acidotic hypercapnic exacerbations of Chronic Obstructive Pulmonary Disease (COPD). The study aims to assess the feasibility of a larger trial to determine if HFNO is not worse than NIV regarding the need for intubation and mortality, while potentially offering improved patient comfort and less nursing effort. This pilot study is prospective, randomized, and multi-center without blinding. Participants will receive either HFNO or NIV as their first line of treatment upon hospital presentation. For HFNO, patients start with a flow of 50 L/min, heated to 37°C, and oxygen levels adjusted to keep oxygen saturation between 88-92%. For NIV, patients will use either a facemask or helmet interface with specified pressure settings tailored for comfort and effective breathing support, also targeting oxygen saturation of 88-92%. All patients receive standard care including monitoring, blood tests, steroids, and inhaled bronchodilators. During the study, patients will be closely monitored for vital signs, respiratory parameters, comfort, and nursing effort from the start and at regular intervals until discharge. The main goal is to measure how feasible it is to conduct a larger randomized controlled trial, focusing on screening, inclusion rates, protocol adherence, and staff feedback. Additional follow-up includes questionnaires three months after admission to assess quality of life without requiring extra visits or blood samples beyond usual care. The total participation duration varies based on hospital stay and follow-up timing.

High Flow Nasal Oxygen for Exacerbation COPD