The primary purpose of this study is to compare and assess the immediate and long-term effects on pulmonary rehabilitation training with the usage of HFNC or conventional oxygen therapy device. The hypotheses was, with high flow nasal cannula usage while exercising, the physiological outcome measurements would be better than conventional oxygen therapy device. Also, the usage of HFNC can immediately increase patient's exercising endurance and decrease dyspnea caused by exercising.
Pulmonary Rehabilitation is one of the most recommended methods to improve the muscle function of COPD patients. By exercise training, even patients with severe COPD can increase muscle strength, improve skeletal muscle function and enhance exercise endurance. Due to improvements in exercise endurance, when exercising at a higher intensity, ventilation support and dynamic hyperinflation would slightly decrease which leads to less dyspnea during exercise. Continuously exercising can also increase the motivation to exercise, reduce mood irritability and psychological burden caused by symptoms. By exercising, patient's health status can be both improved physically and mentally. High Flow Nasal Cannula (HFNC) is a non-invasive ventilatory device that provides stable oxygen concentration, temperature (37℃) and humidity (Relative Humidity: 100%). Humidity provided by the HFNC reduces irritation caused by the high flow, which leads to the increase of user's tolerance with the device. With the half-closed system formed by a nasal prong, when the high flow enters the upper airway, continue positive airway pressure would be formed. Subjects enrolled into this study are required to join a 6-week pulmonary rehabilitation program. Before starting the program, subjects were randomly assigned to high flow nasal cannula group and conventional oxygen therapy group. When exercising, the nasal cannula group would receive an oxygen flow of 3 - 5L to maintain SpO2\>90% and the HFNC group with high flow setting of 45-50Lpm along with oxygen flow of 3-5L also to maintain SpO2\>90%. When joining the pulmonary rehabilitation program, patients are required to exercise for approximately 45 minutes per session. When exercising, changes in the degree of dyspnea, quadriceps blood flow and hemodynamics are assessed. After 6-week of the exercise training, all the parameters will again be assessed and compared to the primary data that was collected from the beginning of the program.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
32
High Flow Nasal Cannula (HFNC) is an oxygen device that increases oxygenation and washes out CO2 within the dead space, it was also clinically used to correct hypoxemia, hypercapnia and respiratory failure.By providing flow rate that is similar to or higher than the patient's inspiratory flow, HFNC is able to provide ventilatory support. To produce stable oxygen concentration, HFNC entrains less air in order to reach the preset value.
Nasal cannula is an oxygen therapy device that has been commonly used as treatment for patients with hypoxemia. With the adjustable flow of 1-6Lpm, the concentration of the oxygen differs as the breathing pattern of the patient changes.
Linkou Chang Gung Memorial Hospital
Taoyuan District, Taiwan
Chang Gung Memorial Hospital
Taoyuan District, Taiwan
Cardiac Output in L/min
Heart rate and stroke volume will be combined to report cardiac output in L/min
Time frame: Changes from baseline to 6 weeks and 12 weeks
COPD Assessment Test (CAT)
Questionnaire designed to evaluate COPD patient's quality of life.
Time frame: Changes from baseline to 6 weeks and 12 weeks
Modified Medical Research Council (mMRC) Dyspnea Scale
Scale to determine the breathlessness of COPD patients during their daily activity
Time frame: Changes from baseline to 6 weeks and 12 weeks
The maximum inspiratory pressure in cmH2O
The maximum inspiratory pressure in cmH2O represents the strength of the abdominal and expiratory muscles
Time frame: Changes from baseline to 6 weeks and 12 weeks
The maximum expiratory pressure in cmH2O
The maximum expiratory pressure in cmH2O
Time frame: Changes from baseline to 6 weeks and 12 weeks
Tissue Saturation Index
Tissue Saturation Index measured by near-Infrared spectroscopy
Time frame: Changes from baseline to 6 weeks and 12 weeks
Total Hemoglobin
Total Hemoglobin measured by near-Infrared spectroscopy
Time frame: Changes from baseline to 6 weeks and 12 weeks
Borg Scale
Scale examining the level of dyspnea or the shortness of breath during exercise
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Time frame: Changes from baseline to 6 weeks and 12 weeks