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Table 3 Physiological effects of flow settings during HFNC treatment for patients with COPD

From: The effects of flow settings during high-flow nasal cannula support for adult subjects: a systematic review

Author/year

Study design

N

Patients

Activity/Breathing pattern

Flow (L/min)

FiO2 or SpO2

RR (breaths/min)

PaCO2 or PtCO2

VT (ml)

MV (L/min)

PTP (cmH2O x Sec/min)

Others

Bräunlich et al. 2016 [21]

Prospective

54

Stable COPD gold C or D

Not specified

20

Not specified

11.6 ± 3.6

91 ± 6.7

534 ± 215

6.0 ± 2.8

NA

MAP: 0.92 ± 0.5

RSBI: 27.4 ± 17.9

30

11.1 ± 3.6

87.4 ± 6.2

524 ± 228

5.6 ± 2.6

NA

MAP: 1.44 ± 0.8

RSBI: 28 ± 18.9

40

10.3 ± 3.3

NA

562 ± 249

5.5 ± 2.5

NA

MAP: 2.14 ± 1

RSBI: 25.1 ± 19.9

50

9.9 ± 2.7

NA

559 ± 260

5.4 ± 2.5

NA

MAP: 3.01 ± 1

RSBI:25.4 ± 18.3

Pisani et al. 2017 [12]

Randomized controlled trial

14

COPD with CHRF

MC

0

Not specified

24.8 ± 2.3

61.2 ± 9.2

314 ± 84

NA

238.3 ± 82.1

PEEPi, dyn: 2.12 ± 0.9

Comfort: 7 (5,8)

\(\Delta\) Pes: 13.5 ± 6.7

MC

20

19.0 ± 5.2

57.2 ± 11.7

391 ± 106

NA

164.2 ± 51.3

PEEPi, dyn: 1.48 ± 0.7

Comfort:5.5 (5,8)

\(\Delta\) Pes: 8.7 ± 4.1

MO

20.8 ± 5.8

NA

NA

NA

172.7 ± 45.4

\(\Delta\) Pes: 12 ± 5.8

MC

30

18.7 ± 3.6

55.7 ± 10.6

364.2 ± 66

NA

143.2 ± 48.9

PEEPi, dyn: 1.03 ± 0.6

Comfort: 5.5 (2,8)

\(\Delta\) Pes: 8.2 ± 3.7

MO

19.6 ± 2.8

NA

NA

NA

157.3 ± 56.9

\(\Delta\) Pes: 10.2 ± 5.2

Bräunlich et al. 2018 [23]

Prospective

36

Stable COPD with CHRF

Not specified

20

Not specified

NA

94.2 ± 8.3a

NA

NA

NA

PaO2: 99.2 ± 18.9a

MAP: 0.57 ± 3.8

40

NA

93.5 ± 4.4a

NA

NA

NA

PaO2: 93.1 ± 15.7a

MAP: 2.3 ± 1.6

Mckinstry et al. 2018 [22]

Randomized controlled trial

48

Stable COPD

Not specified

0

FIO2 0.21

17.5 ± 4.8

38.8 ± 5b

NA

NA

NA

NA

15

16.0 ± 5.7

38.0 ± 5.3b

NA

NA

NA

Comfort:11 (4.5,17,4)

30

13.4 ± 5.2

37.3 ± 6.0b

NA

NA

NA

Comfort:22 (13.8,26.7)

45

13.3 ± 4.8

36.3 ± 5.6b

NA

NA

NA

NA

Rittayamai et al. 2019 [11]

Prospective

12

Hypercapnic COPD

Not specified

10

SpO2 ≥ 92%, FIO2 0.30–0.40

24 (20,29)

41 ± 7b

NA

NA

220 ± 100

SF:271 ± 3c

20

23 (18,28)

41 ± 8b

NA

NA

211 ± 90

SF:274 ± 3c

30

21 (18,27)

41 ± 7b

NA

NA

187 ± 84

SF:277 ± 3c

40

21 (18,27)

41 ± 7b

NA

NA

189 ± 87

SF:277 ± 2c

50

21 (18,26)

41 ± 7b

NA

NA

201 ± 86

SF: 280 ± 2c

Delorme et al. 2017 [24]

Randomized crossover trial

5

Hypercapnic

Not specified

5 ± 4 (baseline)

SpO2 90–94%

NA

NA

NA

15.3 (11.2, 20.0)

192 (161, 245)

WOB: 7.6 (4.0, 8.4)

20

NA

NA

NA

12.1 (7.4, 15.0)

173 (105, 252)

WOB: 4.2 (2.4, 5.2)

40

NA

NA

NA

9.6 (7.6, 20.4)

173 (147, 228)

WOB: 3.7 (3.0, 6.7)

60

NA

NA

NA

12.2 (6.6, 16.3)

145 (79, 235)

WOB: 5.1 (1.8, 5.4)

  1. FiO2 fraction of inspired oxygen (%), SpO2 saturation of oxygenation using pulse oximeter (%), PaCO2 arterial partial pressure of carbon dioxide (mmHg), PtCO2 transcutaneous partial pressure of carbon dioxide (mmHg), PcCO2 capillary partial pressure of carbon dioxide (mmHg), RR respiratory rate (breath/min), \(\Delta\) EELIglob global change in end-expiratory lung impedance measured by electrical impedance tomography, PF PaO2/FiO2, SF SpO2/FiO2, ROX index [ (SpO2/FiO2)/RR], PEEP positive end-expiratory pressure measure by pharyngeal or tracheal catheter, PTP esophageal pressure-time product per minute (cmH2O·s/min), VT tidal volume (ml), MV minute ventilation (L/min), \(\Delta\) Pes esophageal pressure swings (cmH2O), MAP mean airway pressure (mbar), PEEPi dyn dynamic intrinsic positive end-expiratory pressure (cmH2O), WOB work of breathing (J/min), Comfort respiratory comfort level measured by a scale, COPD chronic obstructive pulmonary disease, CHRF chromic hypercapnic respiratory failure, MO mouth opened, MC mouth closed, RSBI rapid shallow breathing index, HFNC high-flow nasal cannula, NA not available
  2. aValue reported as change from baseline (%)
  3. bValue reported as PtCO2
  4. cValues are calculated