高流量鼻导管吸氧疗法对特发性肺纤维化患者运动耐力的影响：一项随机交叉试验。

Effect of high-flow nasal cannula oxygen therapy on exercise tolerance in patients with idiopathic pulmonary fibrosis: A randomized crossover trial.

作者信息

Harada Jumpei, Nagata Kazuma, Morimoto Takeshi, Iwata Kentaro, Matsunashi Atsushi, Sato Yuki, Tachikawa Ryo, Ishikawa Akira, Tomii Keisuke

机构信息

Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan.

Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.

出版信息

Respirology. 2022 Feb;27(2):144-151. doi: 10.1111/resp.14176. Epub 2021 Nov 2.

DOI:10.1111/resp.14176

PMID:34729862

Abstract

BACKGROUND AND OBJECTIVE

Exercise capacity in idiopathic pulmonary fibrosis (IPF) is limited by exercise-induced hypoxaemia. This study aimed to examine the effect of high-flow nasal cannula oxygen therapy (HFNC) on exercise tolerance in patients with IPF.

METHODS

We conducted a single-centre, open-label, randomized crossover trial to compare HFNC and Venturi mask (VM) therapy in terms of exercise tolerance. Patients underwent constant-load symptom-limited exercise testing at 80% peak work rate with HFNC or a VM in a randomized order. The settings were 60 L/min and a 50% fraction of inspired oxygen (FiO ) for HFNC and 12 L/min and 50% FiO for VM. The primary outcome was endurance time, and the secondary outcomes were heart rate (HR), percutaneous oxygen saturation (SpO ), dyspnoea and leg fatigue, as determined by the modified Borg Scale at the isotime and endpoint, and the level of comfort while using the devices.

RESULTS

Twenty-four participants (75.0% men; age, median [interquartile range]: 77.5 [68.8-83.0] years) were enrolled. Compared with VM, HFNC significantly improved the endurance time (647.5 s [454.0-1014.8] vs. 577.5 s [338.0-861.5]), minimum SpO (96.0% [95.0-98.0] vs. 94.0% [92.8-96.0]) and leg fatigue at the isotime (3.0 [1.6-4.0] vs. 5.0 [3.0-6.3]) and endpoint (4.0 [2.8-5.0] vs. 5.0 [3.8-6.3]). Differences in maximum HR, dyspnoea at the isotime and endpoint and comfort were non-significant between HFNC and VM therapy.

CONCLUSION

HFNC increased exercise tolerance in patients with stable IPF experiencing exercise-induced hypoxaemia.

摘要

背景与目的

特发性肺纤维化（IPF）患者的运动能力受运动性低氧血症限制。本研究旨在探讨高流量鼻导管给氧疗法（HFNC）对IPF患者运动耐量的影响。

方法

我们进行了一项单中心、开放标签、随机交叉试验，以比较HFNC和文丘里面罩（VM）疗法对运动耐量的影响。患者以随机顺序在80%峰值工作率下接受恒负荷症状限制运动测试，测试时使用HFNC或VM。HFNC的设置为60升/分钟和50%的吸入氧分数（FiO），VM的设置为12升/分钟和50% FiO。主要结局是耐力时间，次要结局是心率（HR）、经皮血氧饱和度（SpO）、呼吸困难和腿部疲劳，这些指标通过在等时和终点时使用改良的Borg量表进行测定，以及使用设备时的舒适度。

结果

共纳入24名参与者（75.0%为男性；年龄，中位数[四分位间距]：77.5[68.8 - 83.0]岁）。与VM相比，HFNC显著改善了耐力时间（647.5秒[454.0 - 1014.8]对577.5秒[338.0 - 861.5]）、最低SpO（96.0%[95.0 - 98.0]对9,4.0%[9,2.8 - 9,6.0]）以及等时（3.0[1.6 - 4.0]对5.0[3.0 - 6.3]）和终点时（4.0[2.8 - 5.0]对5.0[3.8 - 6.3]）的腿部疲劳。HFNC和VM疗法在最大HR、等时和终点时的呼吸困难以及舒适度方面的差异无统计学意义。