Background. Bronchiectasis is a chronic condition where the airways of the lungs become widened, leading to a build-up of excess mucus. There are no data about High flow nasal cannula (HFNC) therapy on bronchiectasis.

Aim of the study. To determine the effectiveness of long-term HFNC for adult primary and secondary bronchiectasis with frequent acute exacerbations (AE).

Methods. This is a crossover study on home therapy with HFNC in adult bronchiectasis. Patients underwent pharmacological therapy and rehabilitation. After one year daily HFNC was administered for 2 years. The mean set temperature was 34 °C (±2.23). The mean flow was 45 L/m (±4.25). The mean FiO2 was 0.21.

Results. 78 patients completed the follow up. 54% are females. The median age is 70 years (IQR 60-76). The etiology of bronchiectasis is post-infective (51%), COPD related (26%) and congenital (11%). Results are reported in Fig1.

[figure1]

AE at baseline were 2.81 (±2.15). A significant reduction of AE was observed after 24 months with a mean of 0.45 (±0.66) (f-ratio value 79.703. p-value < .00001). A significant reduction of mMRC score was observed after HFNC therapy (2.40±0.81 vs 0.97±0.97 at 2 months vs 0.60±0.78 at 24 months; f-ratio value 95.512. p-value < .00001).

Conclusions. HFNC is a well-tolerated therapy for adult bronchiectasis. Dyspnea improved after 2 months and 2 years. AE rate decreased during the 2 years follow up. No significant difference was observed on lung function.