RT Journal Article SR Electronic T1 β Agonist Delivery by High-Flow Nasal Cannula During COPD Exacerbation JF Respiratory Care FD American Association for Respiratory Care SP 9 OP 15 DO 10.4187/respcare.09242 VO 67 IS 1 A1 Clément Beuvon A1 Rémi Coudroy A1 Justine Bardin A1 Nicolas Marjanovic A1 Christophe Rault A1 Vanessa Bironneau A1 Xavier Drouot A1 René Robert A1 Arnaud W Thille A1 Jean-Pierre Frat YR 2022 UL http://rc.rcjournal.com/content/67/1/9.abstract AB BACKGROUND: Whereas high-flow nasal cannula (HFNC) oxygen therapy is increasingly used in patients with exacerbation of COPD, the effectiveness of β2 agonist nebulization through HFNC has been poorly assessed. We hypothesized that salbutamol vibrating-mesh nebulization through HFNC improves pulmonary function tests in subjects with COPD.METHODS: We conducted a physiological crossover study including subjects admitted to the ICU for severe exacerbation of COPD. After subject improvement allowing a 3-h washout period without bronchodilator, pulmonary function tests were performed while breathing through HFNC alone and after salbutamol vibrating-mesh nebulization through HFNC. The primary end point consisted in the changes in FEV1 before and after salbutamol nebulization. Secondary end points included the changes in FVC, peak expiratory flow (PEF), airway resistance, and clinical parameters.RESULTS: Among the 15 subjects included, mean (SD) FEV1 significantly increased after salbutamol nebulization from 931 mL (383) to 1,019 (432), mean difference +87 mL (95% CI 30–145) (P = .006). Similarly, FVC and PEF significantly increased, +174 mL (95% CI 66–282) (P = .004) and +0.3 L/min (95% CI 0–0.6) (P = .037), respectively. Airway resistances and breathing frequency did not significantly differ, whereas heart rate significantly increased after nebulization.CONCLUSIONS: In subjects with severe exacerbation of COPD, salbutamol vibrating-mesh nebulization through HFNC induced a significant bronchodilator effect with volume and flow improvement.