NHF Post-AECOPD
Research type
Research Study
Full title
The role of nasal high-flow to reduce 30-day hospital readmissions following severe exacerbations of Chronic Obstructive Pulmonary Disease: a mixed-methods feasibility study
IRAS ID
242147
Contact name
Nicholas Hart
Contact email
Sponsor organisation
Guy's and St Thomas' NHS Foundation Trust
ISRCTN Number
ISRCTN15949009
Duration of Study in the UK
2 years, 7 months, 25 days
Research summary
Chronic Obstructive Pulmonary Disease (COPD) is a common lung disease, affecting 1.2 million people in the UK. COPD patients suffer with episodes of worsening breathing symptoms called exacerbations. Exacerbations occur more often as the disease progresses and are a leading cause of emergency hospitalisation. Patients recovering from exacerbations are at high risk of deteriorating, with one quarter readmitted to hospital within thirty days. COPD thus imposes immense burdens on the National Health Service and patients.
This research will investigate the effects of using humidified nasal high-flow (NHF) during recovery from severe COPD exacerbations. NHF delivers warmed, humidified air under flows of up to 60 litres per minute through a nasal interface. This has been shown to improve clinical outcomes, including exacerbation frequency, hospitalisations, breathlessness and quality of life amongst COPD patients with respiratory failure. It is thought to achieve this by improving secretion clearance and providing positive airways pressure which supports the breathing system
Patients admitted to St Thomas’ Hospital, London with COPD exacerbations will be recruited. Prior to discharge, participants will be randomised to receive either usual care alone or usual care plus a NHF device, which they will be trained to use for a regular period daily. Usual care includes inhalers, steroids and may include antibiotics.
Participants will be followed up for 30-days after hospital discharge using weekly assessments, daily symptom diaries and wrist-worn watch-like devices that detect physical activity. This will enable evaluation of the clinical effects of NHF on re-exacerbations, readmissions, breathlessness, physical activity and quality of life. Device usage will also be quantified. Participants who receive devices will be interviewed to explore their experiences. After the 30-day home follow-up period, a sub-group of participants will undergo detailed breathing tests during and after exercise to explore the effects of NHF on the respiratory system.
REC name
London - Harrow Research Ethics Committee
REC reference
19/LO/0194
Date of REC Opinion
20 Mar 2019
REC opinion
Further Information Favourable Opinion