• Yen-Huey Chen, Chung-Chi Huang, Hui-Ling Lin, Shaw-Lang Cheng, and Huang-Pin Wu.
• Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Linko, Taiwan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi Branch, Taiwan.
• J Formos Med Assoc. 2022 Jan 1; 121 (1 Pt 2): 381-387.

BackgroundVentilation limitation has a significant adverse effects on cardiovascular function and tissue oxygenation during exercise in patients with chronic obstructive pulmonary disease (COPD). High flow nasal cannula (HFNC) improve ventilation by washing out the anatomical dead space and providing oxygen at constant concentration. This study aimed to examine the effects of HFNC on the exercise performance and hemodynamic status in COPD patients.MethodsFifteen patients with COPD performed two constant load exercise tests (CLET) at the 70% of maximum workload achieved at a previous incremental exercise test on arm ergometer. The CLET were performed with HFNC and with nasal cannula (NC) in random order. The hemodynamics parameters of subjects during exercises were measured by a bioelectrical impedance device. The tissue oxygenation status (oxygenated hemoglobin, deoxygenated hemoglobin (hHb), total hemoglobin) was measured by a near infrared spectrophotometer.ResultsThe exercise duration was longer for HFNC test than NC test (962.9 ± 281.7 s, vs 823.9 ± 184.9 s, p < 0.05). At the end of CLET, the PetCO2 was lower for HFNC than NC (29.3 ± 5.1 mmHg vs 32.1 ± 5.5 mmHg, p < 0.05). There was no difference in cardiac output (NC: 7.5 ± 1.8 vs HFNC: 7.4 ± 3.0 L,p > 0.05), stroke volume (NC:73.5 ± 21.0 vs HFNC 67.5 ± 16.3 ml, p > 0.05). The changes of hHb in muscle tissues was significantly lower in HFNC test than that in NC test (p < 0.05).ConclusionHFNC resulted in a significant decrease in CO2 production and increase in exercise duration. The application of HFNC may improve the efficiency of exercise training by allowing patients to sustain exercise for longer time.Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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