New Study Shows Humidified High Flow Therapy Improves Flare-Ups

Many COPD patients share a common fear of flare-ups. In the medical world, these are called “acute exacerbations” or AECOPDs. They are a severe health event that happens when a person with COPD has new or worsening symptoms for a period of at least 48 hours. On average, people with COPD experience two episodes of AECOPD every year.

Fortunately, there are new ways to prevent or manage these frustrating flareups. A 2022 clinical study evaluated the effectiveness and safety of high-flow nasal cannula oxygen therapy (HFNC) in people with COPD. This form of treatment delivers heated, humidified air via nasal cannula along with supplemental oxygen if required. Here’s what you should know.

How the study was conducted

One hundred and four (104) COPD patients were recruited from 42 Japanese hospitals and grouped equally to receive either long-term oxygen therapy (LTOT) alone or LTOT along with HFNC. Patients were required to have had at least one moderate or severe exacerbation within the past year.

During the 52-week study period, all patients continued their regular prescribed oxygen therapy during the daytime. The group assigned to use HFNC used the treatment for four or more hours each night while sleeping, with the option of also using it during the daytime if they preferred.

The study participants completed a daily diary to keep track of any worsening symptoms they experienced. Participants also received visits from a doctor every four weeks during the study to evaluate their condition. The primary effect that was focused on was the moderate/severe rate of exacerbation. To measure results, the study compared changes in the baseline of arterial blood gas values, peripheral oxygen saturation, pulmonary function, health-related quality of life scores, and a walk test.



The results showed that HFNC reduced the number of exacerbations that people with COPD experienced and resulted in prolonged periods without moderate or severe exacerbations.

The study concluded that HFNC treatment:

• Significantly reduced the overall rate of moderate COPD exacerbations
• Significantly reduced the overall rate of severe COPD exacerbations
• Prolonged the time between exacerbations

On average, patients in the oxygen group experienced their first exacerbation at 25 weeks, while this was not experienced by patients who were receiving HFNC.

In addition to reducing the risk of exacerbation, HFNC was also shown to significantly improve:

• Health-related quality of life scores
• Specific pulmonary function parameters
• Peripheral oxygen saturation


Should you consider humidified high-flow therapy?

When the body is unable to clear mucus out of the lungs and air passages, it can lead to a higher risk of infection. People who live with COPD often have a hard time clearing the mucus in their lungs, which may cause them to experience frequent coughing, recurring upper respiratory lung infections, and shortness of breath, along with other symptoms.

Humidified air can help improve these symptoms, as it loosens the mucus and encourages the body’s ability to cough up excess phlegm, clearing mucus from the lungs. HFNC is typically prescribed for patients who struggle with excess mucus and cough. This form of therapy hydrates the airways, which can’t be done as effectively with oxygen or BiPAP therapy.

Oftentimes, patients describe HFNC as more comfortable than BiPAP because it simply requires nasal cannulas instead of a sealed mask on the face. This means you can eat, drink, and talk while using it. It’s also a portable treatment, so it can be used anytime, whether you’re awake or asleep.

If you feel that your breathing symptoms aren’t well controlled despite your current medications, especially if you often experience excess mucus, breathlessness, and coughing, talk to your doctor about humidified high-flow therapy.

Most clinical studies about this form of therapy have focused on patients with severe COPD. Even if you have mild or moderate COPD, however, it might be worth it to see if this therapy can help reduce your symptoms. This is especially true if you struggle with high amounts of mucus production and shortness of breath.

Reducing the number of exacerbations is key to managing and slowing the progression of COPD. As shown by the studies mentioned above, HFNC is an effective way to accomplish this. To learn more about exacerbations and what causes them, as well as how to treat them and how they can be prevented, read this article.