• Michelle Lisidati Franchini, Rodrigo Athanazio, Luis Fernando Amato-Lourenço, Waldir Carreirão-Neto, Paulo Hilario Nascimento Saldiva, Geraldo Lorenzi-Filho, Bruce K Rubin, and Nakagawa Naomi Kondo NK Department of Physiotherapy, Communication Science and Disorders and Occupational Therapy, Faculdade de Medicina da Universidade de São Paulo, São.
• Department of Physiotherapy, Communication Science and Disorders and Occupational Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
• Chest. 2016 Aug 1; 150 (2): 407-14.

BackgroundLittle is known about the effects of long-term nasal low-flow oxygen (NLFO) on mucus and symptoms and how this variable is affected by dry or cold humidified gas. The aim of this study was to investigate the effects of dry-NLFO and cold bubble humidified-NLFO on nasal mucociliary clearance (MCC), mucus properties, inflammation, and symptoms in subjects with chronic hypoxemia requiring long-term domiciliary oxygen therapy.MethodsEighteen subjects (mean age, 68 years; 7 male; 66% with COPD) initiating NLFO were randomized to receive dry-NLFO (n = 10) or humidified-NLFO (n = 8). Subjects were assessed at baseline, 12 h, 7 days, 30 days, 12 months, and 24 months by measuring nasal MCC using the saccharin transit test, mucus contact angle (surface tension), inflammation (cells and cytokine concentration in nasal lavage), and symptoms according to the Sino-Nasal Outcome Test-20.ResultsNasal MCC decreased significantly (40% longer saccharin transit times) and similarly in both groups over the study period. There was a significant association between impaired nasal MCC and decline in lung function. Nasal lavage revealed an increased proportion of macrophages, interleukin-8, and epidermal growth factor concentrations with decreased interleukin-10 during the study. No changes in the proportion of ciliated cells or contact angle were observed. Coughing and sleep symptoms decreased similarly in both groups. There were no outcome differences comparing dry vs cold bubble humidified NLFO.ConclusionsIn subjects receiving chronic NLFO, cold bubble humidification does not adequately humidify inspired oxygen to prevent deterioration of MCC, mucus hydration, and pulmonary function. The unheated bubble humidification performed no better than no humidification.Trial RegistryClinicalTrials.gov; No.: NCT02515786; URL: www.clinicaltrials.gov.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

45 keywords...

hide…