Comparing High Flow Nasal Cannula and Home Mechanical Ventilation for COPD Patients with Persistent High Carbon Dioxide After Severe Exacerbation A Randomized Crossover Study

What this Trial Is About

Researchers are evaluating respiratory strategies in patients with COPD and persistent high carbon dioxide levels following a severe flare-up. This study compares two treatments high flow nasal cannula NHF combined with standard oxygen therapy, and home mechanical ventilation HMV combined with standard oxygen therapy. The goal is to determine if NHF provides similar benefits to HMV in reducing carbon dioxide levels in the blood. Participants will be randomly assigned to start with either NHF plus oxygen therapy or HMV plus oxygen therapy. Each treatment lasts three months, separated by a one-week washout period to avoid carry-over effects. The total treatment duration, including the washout, is around 25 weeks. NHF involves using a device delivering heated, humidified air through nasal cannula for at least six hours nightly, while HMV uses a ventilator with a mask for at least six hours nightly plus oxygen therapy for at least 15 hours daily. During the study, participants will undergo assessments at baseline, after three months, and after six months, including blood gas tests to measure carbon dioxide and oxygen levels, lung function tests, exercise capacity tests, symptom and quality of life questionnaires, and sleep quality evaluations. Compliance and tolerance to each respiratory support will be monitored by device usage data and patient feedback. Researchers will also track exacerbations, hospitalizations, and survival over 12 months to evaluate the treatments effects.

Respiratory Strategies in COPD Patients With Persistent Hypercapnia Following Exacerbation