Summary: The effects of high-flow vs low-flow oxygen on exercise in advanced obstructive airways disease.
Topic: Work of Breathing
The effects of high-flow vs low-flow oxygen on exercise in advanced obstructive airways disease by Chatila, W, Nugent, T, Vance, G, Gaughan, J, & Criner, GJ (CHEST 2004: 126, 1108-15).
Chatila et al showed that adult patients with airflow restriction were able to exercise longer (p < 0.05) on high flow oxygen therapy (HFT; 20 l/min) than on conventional low flow oxygen (< 6 l/min) despite matched FIO2. In addition to the overall longer performance, during HFT patients demonstrated lower dyspnea scores (p < 0.03), improved breathing patterns (RR, RR/Vt; p < 0.05), and lower arterial pressure (p < 0.05) and better oxygenation (p < 0.001). This study supports Vapotherm’s proposed mechanisms of action with respect to improving both oxygen and CO2 composition of alveolar gas by way of dead space elimination. The patients oxygenation indices were reported as significantly improved, plus the improvement in exercise time while demonstrating a lower breathing rate would indicate an effect on CO2 (CO2 was not different despite differences in work). Furthermore, the patients’ Ti/Ttotal was lower (p < 0.05) on HFT which may be indicative of reduced airway resistance.
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High Velocity Therapy in Critical Care