Abstrakt

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the airways characterized by progressive, only partially reversible obstruction and destruction of the small airways, leading to expiratory flow limitation. The disease is heterogeneous and encompasses phenotypes such as chronic bronchitis, pulmonary emphysema, and the pulmonary vascular phenotype. Hypercapnia (elevated blood CO2 levels) in COPD results from an imbalance between increased respiratory drive and decreased respiratory pump capacity. Nasal high-flow (NHF) therapy delivers up to 60 L/min of heated and humidified oxygen and has established itself as a treatment option between conventional oxygen therapy and non-invasive ventilation (NIV). Physiologically, NHF improves breathing by flushing out anatomical dead space (reducing CO2 rebreathing), promoting mucociliary clearance, and generating positive airway pressure. Recent studies suggest the superiority of NHF therapy over long-term oxygen therapy (LTOT) in mildly hypercapnic COPD patients. NHF has been shown to reduceNasale High-Flow Therapie bei hyperkapnischen COPD Patienten 537 the risk of moderate to severe exacerbations and hospitalizations while maintaining PaCO2 levels stable or even lowering them during sleep. NHF therapy may represent an alternative to NIV for chronically hypercapnic COPD patients, particularly in cases of NIV intolerance. Current studies suggested non-inferiority of NHF compared to NIV in terms of PCO2 reduction, with NHF often being associated with greater patient comfort. Evidence on the role of NHF in acute COPD exacerbations with hypercapnic respiratory failure is limited. Initial studies show no inferiority of NHF to NIV with regard to intubation risk, although the greater comfort of NHF has been highlighted. Larger, ongoing studies are needed to conclusively clarify the value of NHF in this acute setting.

Autoreninformation

Autoren

• M. Khalaf¹
• G. Nilius²

Abteilungen

• ¹ Kliniken Essen Mitte,
• ² Klinikum Dortmund, Universität Witten-Herdecke, Dortmund

Adresse

Prof. Dr. Georg Nilius
Klinikum Dortmund gGmbH
Münsterstr. 240
44145 Dortmund
Email: [email protected]

Citation