High Flow Nasal Therapy during exercise in CF

High-flow nasal therapy during exercise in patients with cystic fibrosis and severe lung disease: a pilot study to assess feasibility

High flow nasal therapy (HFNT) is a way to deliver a mixture of air and oxygen at higher flows compared to standard oxygen therapy. It has been shown to improve oxygenation, reduce breathlessness and breathing rate, and is quite comfortable. Recently HFNT has been shown to improve exercise capacity and tolerance in patients with other lung diseases. HFNT is routinely used in clinical practice in patients with CF who present acutely unwell during hospital admissions. We believe that HFNT could be used by patients with CF during exercise in order to improve their tolerance, lengthen their exercise sessions, and allow them to be less symptomatic. We propose an initial, small-scale pilot study to assess the feasibility of a larger trial to assess efficacy. The study aims to enrol 20 patients with severe lung disease, during a hospital admission. On top of their routine 6-minute walking test, patients will be asked to have a repeated test on HFNT and to fill in a questionnaire on their physical activity. As exploratory outcomes, we will measure distance walked during the tests, oxygen and carbon dioxide levels, breathing rate, and time to recover to baseline. Patients will be asked to rate their comfort and their breathlessness.