https://doi.org/10.4081/monaldi.2022.2333

Acute and long-term management of severe bronchiectasis with high flow nasal therapy: a case report

Vol. 93 No. 2 (2023)
Submitted: May 20, 2022
Accepted: August 1, 2022
Published: August 4, 2022
Bronchiectasis, exacerbation, high flow nasal therapy, high flow nasal oxygen, HFNT, HFNO, acute, long-term, domiciliary
Abstract Views: 2134
PDF: 735
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Pietro Impellizzeri
Department of Clinical and Experimental Medicine, University of Catania, Italy.
Santi Nolasco
https://orcid.org/0000-0003-3995-7662
Department of Clinical and Experimental Medicine, University of Catania, Italy.
Raffaele Campisi
Respiratory Medicine Unit, Policlinico “G. Rodolico - San Marco” University Hospital, Catania, Italy.
Antonino Cipolla
https://orcid.org/0000-0003-0494-1644
Department of Clinical and Experimental Medicine, University of Catania, Italy.
Alba Borgese
Department of Clinical and Experimental Medicine, University of Catania, Italy.
Stefano Alia
https://orcid.org/0000-0002-7848-862X
Respiratory Medicine Unit, Policlinico “G. Rodolico - San Marco” University Hospital, Catania, Italy, Italy.
Nunzio Crimi
Department of Clinical and Experimental Medicine, University of Catania, Italy.
Claudia Crimi
dott.claudiacrimi@gmail.com
https://orcid.org/0000-0002-9088-5214
Respiratory Medicine Unit, Policlinico “G. Rodolico - San Marco” University Hospital, Catania, Italy.

Bronchiectasis (BE) is a long-term, chronic lung condition featured by widened and scarred airways. These can alter the physiological mucociliary clearance, making it difficult to clear mucus and microorganisms, leading to frequent exacerbations. High flow nasal therapy (HFNT) is a noninvasive respiratory support that delivers heated and humidified gas eventually enriched with oxygen, through a nasal cannula.  Humidification is crucial for adequate airways mucociliary clearance, improving ciliary function and consequently reducing airways inflammation and recurrent infections. HFNT has been mostly used in patients with acute hypoxemic respiratory failure and in selected patients with chronic respiratory failure due to COPD. Still, evidence about its use in acute and long-term home setting in patients with clinically relevant BE are lacking. We report a case of severe widespread BE, already on top medical therapy and pulmonary rehabilitation, still suffering from difficult mucus expectoration and recurrent exacerbations, who has been additionally treated with HFNT, both in hospital and domiciliary, reporting significant improvements on relevant clinical and patient-centered outcomes. Thus, HFNT may confer additional benefits as an add-on treatment of patients with severe BE and respiratory failure.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Aliberti S, Goeminne PC, O’Donnell AE, et al. Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: international consensus recommendations. Lancet Respir Med 2022;10:298-306. DOI: https://doi.org/10.1016/S2213-2600(21)00277-0
Hasani A, Chapman TH, McCool D, et al. Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis. Chron Respir Dis 2008;5:81-6. DOI: https://doi.org/10.1177/1479972307087190
Kilgour E, Rankin N, Ryan S, Pack R. Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity. Intensive Care Med 2004;30:1491–4. DOI: https://doi.org/10.1007/s00134-004-2235-3
Chidekel A, Zhu Y, Wang J, et al. The effects of gas humidification with high-flow nasal cannula on cultured human airway epithelial cells. Pulm Med 2012;2012:380686. DOI: https://doi.org/10.1155/2012/380686
Crimi C, Noto A, Cortegiani A, et al. High flow nasal therapy use in patients with acute exacerbation of COPD and bronchiectasis: A feasibility study. COPD 2020;17:184–90. DOI: https://doi.org/10.1080/15412555.2020.1728736
Rea H, McAuley S, Jayaram L, et al. The clinical utility of long-term humidification therapy in chronic airway disease. Respir Med 2010;104:525–33. DOI: https://doi.org/10.1016/j.rmed.2009.12.016
Good WR, Garrett J, Hockey HUP, et al. The role of high-flow nasal therapy in bronchiectasis: a post hoc analysis. ERJ Open Res 2021;7:00711–2020. DOI: https://doi.org/10.1183/23120541.00711-2020
Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J 2017;50:1700629. DOI: https://doi.org/10.1183/13993003.00629-2017
Pasteur MC, Helliwell SM, Houghton SJ, et al. An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med 2000;162:1277–84. DOI: https://doi.org/10.1164/ajrccm.162.4.9906120
Wilson CB, Jones PW, O’leary CJ, et al. Validation of the St. George’s Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med 1997;156:536–41. DOI: https://doi.org/10.1164/ajrccm.156.2.9607083
Wanner A, Salathé M, O’Riordan TG. Mucociliary clearance in the airways. Am J Respir Crit Care Med 1996;154:1868–902. DOI: https://doi.org/10.1164/ajrccm.154.6.8970383
Houtmeyers E, Gosselink R, Gayan-Ramirez G, Decramer M. Regulation of mucociliary clearance in health and disease. Eur Respir J 1999;13:1177–88. DOI: https://doi.org/10.1034/j.1399-3003.1999.13e39.x
Williams R, Rankin N, Smith T, et al. Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med 1996;24:1920–9. DOI: https://doi.org/10.1097/00003246-199611000-00025
Fuschillo S, De Felice A, Balzano G. Mucosal inflammation in idiopathic bronchiectasis: cellular and molecular mechanisms. Eur Respir J 2008;31:396-406. DOI: https://doi.org/10.1183/09031936.00069007
Fontanari P, Zattara-Hartmann MC, Burnet H, Jammes Y. Nasal eupnoeic inhalation of cold, dry air increases airway resistance in asthmatic patients. Eur Respir J 1997;10:2250–4. DOI: https://doi.org/10.1183/09031936.97.10102250
Parke R, McGuinness S, Eccleston M. Nasal high-flow therapy delivers low level positive airway pressure. Br J Anaesth 2009;103:886–90. DOI: https://doi.org/10.1093/bja/aep280
Cortegiani A, Longhini F, Madotto F, Groff P et al. High flow nasal therapy versus noninvasive ventilation as initial ventilatory strategy in COPD exacerbation: a multicenter non-inferiority randomized trial. Crit Care 2020;24:692. DOI: https://doi.org/10.1186/s13054-020-03409-0
Nagata K, Kikuchi T, Horie T, et al. Domiciliary high-flow nasal cannula oxygen therapy for patients with stable hypercapnic chronic obstructive pulmonary disease. A multicenter randomized crossover trial. Ann Am Thorac Soc 2018;15:432–9. DOI: https://doi.org/10.1513/AnnalsATS.201706-425OC
Crimi C, Ferri S, Crimi N. Bronchiectasis and asthma: a dangerous liaison Curr Opin Allergy Clin Immunol 2019;19:46–52. DOI: https://doi.org/10.1097/ACI.0000000000000492
Boucher RC. Muco-obstructive lung diseases. N Engl J Med 2019;380:1941–53. DOI: https://doi.org/10.1056/NEJMra1813799

How to Cite

Impellizzeri, Pietro, Santi Nolasco, Raffaele Campisi, Antonino Cipolla, Alba Borgese, Stefano Alia, Nunzio Crimi, and Claudia Crimi. 2022. “Acute and Long-Term Management of Severe Bronchiectasis With High Flow Nasal Therapy: A Case Report”. Monaldi Archives for Chest Disease 93 (2). https://doi.org/10.4081/monaldi.2022.2333.
Copyright (c) 2022 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.