Domiciliary high-flow nasal cannula oxygen therapy for stable hypercapnic chronic obstructive pulmonary disease: a prospective, multicentre, randomised crossover trial

Background: High-flow nasal cannula oxygen therapy (HFNC) may have the potential to support breathing in patients with chronic respiratory failure. However, it remains unclear whether long-term domiciliary use of HFNC has clinical benefits for patients with chronic hypercapnic respiratory failure due to chronic obstructive pulmonary disease (COPD). Methods: A multicentre, prospective, randomised crossover trial comparing HFNC plus long-term oxygen therapy (LTOT) with LTOT only was performed in patients with stable hypercapnic COPD. The patients initially received either HFNC plus LTOT (group A) or LTOT only (group B) for 6 weeks and then crossed over to the alternative treatment. Results: Twenty-nine patients (13 in group A, and 16 in group B) completed the crossover treatments. Mean flow rate of HFNC was around 30 L/min, and mean usage time was 8.2 hours/day. The mean total score of the COPD-specific version of the St. George’s Respiratory Questionnaire was significantly improved in the HFNC plus LTOT compared with the LTOT only (-7.8 points, p Conclusions: HFNC improved health-related quality of life and hypercapnia in patients with stable hypercapnic COPD. HFNC may be a promising therapeutic option for these patients.