Effects of High Flow Nasal Cannula on Sputum Clearance in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Reason given: The pandemic interefered with the progresion of study activity.
Key facts
- Where
- Boston, United StatesSee the site
Where in United States
- Tufts Medical CenterBoston, United StatesNo longer taking part
Trial details
- Who runs it
- Tufts Medical Center
- Trial code
- NCT04217746
- Record updated
- 22 July 2025
- Original description
Acute exacerbation of COPD usually presents with more sputum production leading to worsening airflow obstruction. Often patients complain of sensation of sputum (phlegm) stuck in throat, which leads to worsening cough and respiratory distress. In an acute exacerbation setting high flow nasal cannula (HFNC), which is a modality that provides humidified and warm oxygenated air at flow of upto 60L/min, has shown to reduce blood carbon dioxide level and respiratory rate. However, studies investigating other effects of HFNC in this setting are lacking. To investigators' knowledge, this is the first study investigating effects of HFNC on sputum clearance in COPD patients.Read full original descriptionShow less
Acute exacerbation of COPD usually presents with more sputum production leading to worsening airflow obstruction. Often patients complain of sensation of sputum (phlegm) stuck in throat, which leads to worsening cough and respiratory distress. In an acute exacerbation setting high flow nasal cannula (HFNC), which is a modality that provides humidified and warm oxygenated air at flow of upto 60L/min, has shown to reduce blood carbon dioxide level and respiratory rate. However, studies investigating other effects of HFNC in this setting are lacking. To investigators' knowledge, this is the first study investigating effects of HFNC on sputum clearance in COPD patients.
The purpose of the study is to determine the effects of HFNC on sputum clearance in acute exacerbation of COPD. Primary objective of the study is to determine whether HFNC improves clearability and wettability of sputum produced during acute exacerbation of COPD. Secondary objectives of the study include subjective assessment of cough severity as well as need for escalation of care after HFNC use versus conventional flow nasal oxygen (CFNO) use.
Inclusion: Age ≥ 18 years old; Known COPD or high probability of the disease according to treating physician based on clinical history, physical examination and chest imaging; Hospital admission for acute exacerbation of COPD defined by 2018 GOLD report as acute worsening of respiratory symptoms (more than baseline cough, sputum purulence or volume, dyspnea or wheeze) that result in additional therapy; Presence of one or more of following: increase in sputum production, change in sputum color or difficulty in expectorating sputum.
Exclusion: Respiratory failure requiring non-invasive ventilation (NIV) or endotracheal intubation; Severely impaired cough, impaired swallowing or chronic aspiration due to neuromuscular disorder; Inability to obtain informed consent from the patient or legally authorized representative; Inability of the subject to cooperate with protocol; Presence of idiopathic bronchiectasis or cystic fibrosis; Patients with poor short term prognosis not expected to survive the hospitalization; Massive hemoptysis; Patients presenting with coma (Glasgow coma scale <10) or circulatory shock; Facial deformity or injury leading to difficulty in wearing high flow nasal cannula appropriately; Enrollment in other investigative protocols with apparent overlap; Prisoners.