Standard of care for patients who have acute COPD exacerbations with hypercapnia is to provide the patients with steroids, nebulizations, supplemental oxygen, and positive pressure. What if I were to tell you that one could potentially with the high flow nasal cannula systems to treat COPD exacerbations? Well, that’s why you’re here on this page. It is definitely a work-in-progress and it was last updated on 11/1/21. For now, all I have here are some citations with links so you can go down the rabbit hole of using HFNC in COPD exacerbations yourself.

Check out past posts on HFNC and NIV HERE.

Citations for Articles of High Flow in COPD

Bräunlich J, Dellweg D, Bastian A, Budweiser S, Randerath W, Triché D, Bachmann M, Kähler C, Bayarassou AH, Mäder I, Geiseler J, Köhler N, Petroff D, Wirtz H. Nasal high-flow versus noninvasive ventilation in patients with chronic hypercapnic COPD. Int J Chron Obstruct Pulmon Dis. 2019 Jul 5;14:1411-1421. doi: 10.2147/COPD.S206111. PMID: 31308647; PMCID: PMC6615713.
Link to Article
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Bräunlich J, Köhler M, Wirtz H. Nasal highflow improves ventilation in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2016 May 25;11:1077-85. doi: 10.2147/COPD.S104616. PMID: 27307723; PMCID: PMC4887061.
Link to Article
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Pantazopoulos I, Daniil Z, Moylan M, Gourgoulianis K, Chalkias A, Zakynthinos S, Ischaki E. Nasal High Flow Use in COPD Patients with Hypercapnic Respiratory Failure: Treatment Algorithm & Review of the Literature. COPD. 2020 Feb;17(1):101-111. doi: 10.1080/15412555.2020.1715361. Epub 2020 Jan 22. PMID: 31965868.
Link to Article (NOT FREE)

Pisani L, Astuto M, Prediletto I, Longhini F. High flow through nasal cannula in exacerbated COPD patients: a systematic review. Pulmonology. 2019 Nov-Dec;25(6):348-354. doi: 10.1016/j.pulmoe.2019.08.001. Epub 2019 Oct 5. PMID: 31591056.
Link to Article
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Pisani L, Betti S, Biglia C, Fasano L, Catalanotti V, Prediletto I, Comellini V, Bacchi-Reggiani L, Fers SN. Effects of high-flow nasal cannula in patients with persistent hypercapnia after an acute COPD exacerbation: a prospective pilot study. BMC Pulm Med. 2020 Jan 13;20(1):12. doi: 10.1186/s12890-020-1048-7. PMID: 31931776; PMCID: PMC6958745.
Link to Article
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Sun J, Li Y, Ling B, Zhu Q, Hu Y, Tan D, Geng P, Xu J. High flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: an observational cohort study. Int J Chron Obstruct Pulmon Dis. 2019 Jun 5;14:1229-1237. doi: 10.2147/COPD.S206567. Erratum in: Int J Chron Obstruct Pulmon Dis. 2019 Jul 15;14:1567. PMID: 31239658; PMCID: PMC6556470.
Link to Article
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Cortegiani A, Longhini F, Carlucci A, Scala R, Groff P, Bruni A, Garofalo E, Taliani MR, Maccari U, Vetrugno L, Lupia E, Misseri G, Comellini V, Giarratano A, Nava S, Navalesi P, Gregoretti C. High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol for a noninferiority randomized clinical trial. Trials. 2019 Jul 22;20(1):450. doi: 10.1186/s13063-019-3514-1. PMID: 31331372; PMCID: PMC6647141.
Link to Article
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Lee MK, Choi J, Park B, Kim B, Lee SJ, Kim SH, Yong SJ, Choi EH, Lee WY. High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure. Clin Respir J. 2018 Jun;12(6):2046-2056. doi: 10.1111/crj.12772. Epub 2018 Mar 5. PMID: 29392846.
Link to Article (NOT FREE)

Tan D, Walline JH, Ling B, Xu Y, Sun J, Wang B, Shan X, Wang Y, Cao P, Zhu Q, Geng P, Xu J. High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial. Crit Care. 2020 Aug 6;24(1):489. doi: 10.1186/s13054-020-03214-9. PMID: 32762701; PMCID: PMC7407427.
Link to Article
Link to FULL FREE PDF

Response to Tan et al. article
Curtis RV, Kabchi BA, Alqalyoobi S. High-flow nasal cannula can’t be considered non-inferior to noninvasive ventilation in patients with chronic obstructive pulmonary disease who develop respiratory failure after extubation. Crit Care. 2020 Nov 23;24(1):659. doi: 10.1186/s13054-020-03363-x. PMID: 33228758; PMCID: PMC7684711.
Link to Article
Link to FULL FREE PDF

Yang PL, Yu JQ, Chen HB. High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis. Heart Lung. 2021 Mar-Apr;50(2):252-261. doi: 10.1016/j.hrtlng.2020.12.010. Epub 2020 Dec 22. PMID: 33359930.
Link to Article (NOT FREE)

Hill NS. High Flow Nasal Cannula, Is There a Role in COPD? Tanaffos. 2017;16(Suppl 1):S12. PMID: 29158751; PMCID: PMC5684725.
Link to Article
Link to FULL FREE PDF

Tasota FJ, Kress TL, Conlin TL, Scarmack NM. Nasal cannula or high-flow oxygen for patients with COPD in acute respiratory distress? Nursing. 2021 May 1;51(5):52-57. doi: 10.1097/01.NURSE.0000743096.13461.b6. PMID: 33885433.
Link to Article

Xia J, Gu S, Lei W, Zhang J, Wei H, Liu C, Zhang H, Lu R, Zhang L, Jiang M, Hu C, Cheng Z, Wei C, Chen Y, Lu F, Chen M, Bi H, Liu H, Yan C, Teng H, Yang Y, Liang C, Ge Y, Hou P, Liu J, Gao W, Zhang Y, Feng Y, Tao C, Huang X, Pan P, Luo H, Yun C, Zhan Q. High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial. Crit Care. 2022 Apr 15;26(1):109. doi: 10.1186/s13054-022-03973-7. PMID: 35428349; PMCID: PMC9013098.
Link to Article
Link to FULL FREE PDF

Longhini F, Pisani L, Lungu R, Comellini V, Bruni A, Garofalo E, Laura Vega M, Cammarota G, Nava S, Navalesi P. High-Flow Oxygen Therapy After Noninvasive Ventilation Interruption in Patients Recovering From Hypercapnic Acute Respiratory Failure: A Physiological Crossover Trial. Crit Care Med. 2019 Jun;47(6):e506-e511. doi: 10.1097/CCM.0000000000003740. PMID: 30882477.
LINK TO (NOT FREE) Article

Rittayamai N, Phuangchoei P, Tscheikuna J, Praphruetkit N, Brochard L. Effects of high-flow nasal cannula and non-invasive ventilation on inspiratory effort in hypercapnic patients with chronic obstructive pulmonary disease: a preliminary study. Ann Intensive Care. 2019 Oct 22;9(1):122. doi: 10.1186/s13613-019-0597-5. PMID: 31641959; PMCID: PMC6805835.
Link to Article
Link to FULL FREE PDF

Xu Z, Zhu L, Zhan J, Liu L. The efficacy and safety of high-flow nasal cannula therapy in patients with COPD and type II respiratory failure: a meta-analysis and systematic review. Eur J Med Res. 2021 Oct 14;26(1):122. doi: 10.1186/s40001-021-00587-7. PMID: 34649617; PMCID: PMC8515156.
Link to Article
Link to FULL FREE PDF

Du Y, Zhang H, Ma Z, Liu J, Wang Z, Lin M, Ni F, Li X, Tan H, Tan S, Chai Y, Zhong X. High-Flow Nasal Oxygen versus Noninvasive Ventilation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients: A Meta-Analysis of Randomized Controlled Trials. Can Respir J. 2023 Jun 30;2023:7707010. doi: 10.1155/2023/7707010. PMID: 37426578; PMCID: PMC10328729.
Link to Article
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