The clinical utility of long-term humidification therapy in chronic airway disease.
OBJECTIVE
Persistent airway inflammation with mucus retention in patients with chronic airway disorders such as COPD and bronchiectasis may lead to frequent exacerbations, reduced lung function and poor quality of life. This study investigates if long-term humidification therapy with high flow fully humidified air at 37 degrees C through nasal cannulae can improve these clinical outcomes in this group of patients.


METHODS
108 patients diagnosed with COPD or bronchiectasis were randomised to daily humidification therapy or usual care for 12 months over which exacerbations were recorded. Lung function, quality of life, exercise capacity, and measures of airway inflammation were also recorded at baseline, 3 and 12 months.


RESULTS
Patients on long-term humidification therapy had significantly fewer exacerbation days (18.2 versus 33.5 days; p = 0.045), increased time to first exacerbation (median 52 versus 27 days; p = 0.0495) and reduced exacerbation frequency (2.97/patient/year versus 3.63/patient/year; p = 0.067) compared with usual care. Quality of life scores and lung function improved significantly with humidification therapy compared with usual care at 3 and 12 months.


CONCLUSIONS
Long-term humidification therapy significantly reduced exacerbation days, increased time to first exacerbation, improved lung function and quality of life in patients with COPD and bronchiectasis. Clinical trial registered with www.actr.org.au; Number ACTRN2605000623695.
Rea
Harold
H
University of Auckland, Auckland, New Zealand.
McAuley
Sue
S
Jayaram
Lata
L
Garrett
Jeffrey
J
Hockey
Hans
H
Storey
Louanne
L
O'Donnell
Glenis
G
Haru
Lynne
L
Payton
Matthew
M
O'Donnell
Kevin
K
D000368:Aged; D001987:Bronchiectasis / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D006813:Humidity; D008297:Male; D009520:New Zealand; D010102:Oxygen Inhalation Therapy / Q000401:mortality* / Q000706:statistics & numerical data; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome