C97-05 High-flow Nasal Cannula (HFCN) to Improve Exercise Capacity in Patients With Interstitial Lung Disease (ILD): Results From a Pilot Single-center Study

Abstract Background Physical exercise is considered one of the most effective maintenance measures for patients with interstitial lung disease (ILD). Dyspnea and hypoxemia negatively impact exercise tolerance in ILD patients.The HFNC (High-Flow Nasal Cannula) is an innovative device that delivers heated and humidified oxygen with a maximum flow rate of 60 l/min via a nasal cannula. The study was aimed at investigating whether HFNC can improve exercise capacity in ILD patients compared to low-flow oxygen therapy (LFOT). Methods We recruited ILD patients with a board certified ILD diagnosis, SpO2 88% at rest, and no need of oxygen treatment. Patients with concomitant ILD exacerbations and clinically relevant comorbidities were excluded. The incremental exercise test, with administration of 10 watts (W) per minute, was performed using a bicycle ergometer. In arm A, patients first performed the test under LFOT (2L/min through a conventional cannula) and then repeated the text using HFNC (Vapotherm Precision Flow®). In arm B, the test was performed in reverse order. There was a one-hour break between the tests. HFNC was administered at a flow rate of 30 L/min and an inspiratory oxygen fraction (FiO2) of 0.4.The subjects pedaled until they could no longer tolerate the exercise. The primary endpoint was endurance time; other endpoints included SpO2, heart rate (HR), and dyspnea measured by Borg scale. Results Thirty consecutive patients with ILD (10 F, 20 M, mean age 60±8 years, mean FVC % pred. 65±17) were recruited. All the patients completed the study according to protocol. The mean difference in endurance time between patients under LFOT and HFNC was 16.1 seconds (95% CI 0.4-31.9, p = 0.03). Endurance intensity was significantly higher with HFNC compared to LFOT (62.5±20.5 vs. 58.7±23.1 W, p = 0.004). No significant differences were observed in the other secondary endpoints. Conclusion The use of HFNC resulted in a significant increase in exercise duration and intensity compared to LFOT. The use of HFNC during rehabilitation is likely to improve the efficiency of physical training in ILD patients by prolonging exercise time. This abstract is funded by: none