{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T17:11:14Z","timestamp":1784653874382,"version":"3.55.0"},"reference-count":40,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: High-flow nasal therapy (HFNT) has been shown to reduce exacerbations of COPD and some evidence displays benefits in non-cystic fibrosis bronchiectasis (NCFB) patients. The present study aimed to compare the effectiveness of 12 months of home HFNT on the annual exacerbation rate between mild\/moderate and severe NCFB patients, classified by the bronchiectasis severity index (BSI). Secondary outcomes were the evaluation of the dyspnea, pulmonary function, and sputum cultures in both groups. Methods: The study population included NCFB adult patients, with at least one severe exacerbation in the previous year on optimized therapy. NCFB exacerbations, dyspnea (mMRC score), pulmonary function test, and sputum cultures were assessed at baseline and after 12 months of HFNT. Results: A total of 86 NCFB patients were enrolled: 36 in the mild\/moderate (BSI &lt; 9) and 50 in the severe (BSI \u2265 9) group. A significant improvement in the annual exacerbation rate was found in both BSI \u2265 9 (p &lt; 0.0001) and BSI &lt; 9 cohorts (p &lt; 0.0001), with a between-group difference of \u22121 (95% CI: \u22122 to 0) exacerbations per year (p = 0.0209). The change in the annual exacerbation rate was significantly correlated with BSI (\u03c1 = \u22120.26, p = 0.0151) and with HFNT daily use (\u03c1 = \u22120.22, p = 0.0460). The mMRC score significantly improved by \u22122 points (95% CI: \u22122 to \u22121) after treatment in both groups (p &lt; 0.0001). The percentage of patients with P. aeruginosa colonization decreased from 34.9% to 27.9%. Conclusions: Long-term HFNT reduces the annual exacerbation rate in NCFB patients and its effectiveness increases alongside disease severity and daily use of HFNT.<\/jats:p>","DOI":"10.3390\/jcm13206146","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T07:58:32Z","timestamp":1729065512000},"page":"6146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Long-Term High-Flow Nasal Therapy in Patients with Bronchiectasis of Different Severity: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4293-4461","authenticated-orcid":false,"given":"Cecilia","family":"Calabrese","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Azienda Ospedaliera di Rilievo Nazionale dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-7662","authenticated-orcid":false,"given":"Santi","family":"Nolasco","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy"},{"name":"Respiratory Medicine Unit, Policlinico \u201cG. Rodolico-San Marco\u201d University Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-3545","authenticated-orcid":false,"given":"Anna","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Department of Respiratory Pathophysiology and Rehabilitation, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Sola","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Azienda Ospedaliera di Rilievo Nazionale dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-1746","authenticated-orcid":false,"given":"Pasquale","family":"Imitazione","sequence":"additional","affiliation":[{"name":"Department of Respiratory Pathophysiology and Rehabilitation, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9305-6748","authenticated-orcid":false,"given":"Raffaele","family":"Campisi","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Unit, Policlinico \u201cG. Rodolico-San Marco\u201d University Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9457-6558","authenticated-orcid":false,"given":"Francesca","family":"Simioli","sequence":"additional","affiliation":[{"name":"Department of Respiratory Pathophysiology and Rehabilitation, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Balestrino","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Azienda Ospedaliera di Rilievo Nazionale dei Colli, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ferrentino","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5120-9926","authenticated-orcid":false,"given":"Carlo","family":"Vancheri","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy"},{"name":"Respiratory Medicine Unit, Policlinico \u201cG. Rodolico-San Marco\u201d University Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9088-5214","authenticated-orcid":false,"given":"Claudia","family":"Crimi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy"},{"name":"Respiratory Medicine Unit, Policlinico \u201cG. Rodolico-San Marco\u201d University Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2523-9769","authenticated-orcid":false,"given":"Giuseppe","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Department of Respiratory Pathophysiology and Rehabilitation, Monaldi Hospital, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/S2213-2600(21)00277-0","article-title":"Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: International consensus recommendations","volume":"10","author":"Aliberti","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1056\/NEJMra2202819","article-title":"Bronchiectasis\u2014A Clinical Review","volume":"387","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Du, Q., Jin, J., Liu, X., and Sun, Y. (2016). Bronchiectasis as a Comorbidity of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0150532"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1183\/13993003.01033-2015","article-title":"Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: A population-based cohort study","volume":"47","author":"Quint","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1802033","DOI":"10.1183\/13993003.02033-2018","article-title":"Economic burden of bronchiectasis in Germany","volume":"53","author":"Diel","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1164\/ajrccm.162.2.9910086","article-title":"Tobramycin solution for inhalation reduces sputum Pseudomonas aeruginosa density in bronchiectasis","volume":"162","author":"Barker","year":"2000","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"00151","DOI":"10.1183\/23120541.00151-2024","article-title":"Brensocatib in non-cystic fibrosis bronchiectasis: ASPEN protocol and baseline characteristics","volume":"10","author":"Chalmers","year":"2024","journal-title":"ERJ Open Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"00674-2022","DOI":"10.1183\/23120541.00674-2022","article-title":"Airway clearance technique in the modern era of bronchiectasis management","volume":"9","author":"Pan","year":"2023","journal-title":"ERJ Open Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2202053","DOI":"10.1183\/13993003.02053-2022","article-title":"European Respiratory Society statement on airway clearance techniques in adults with bronchiectasis","volume":"62","author":"Lee","year":"2023","journal-title":"Eur. Respir. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s00134-004-2235-3","article-title":"Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity","volume":"30","author":"Kilgour","year":"2004","journal-title":"Intensive Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/1479972307087190","article-title":"Domiciliary humidification improves lung mucociliary clearance in patients with bronchiectasis","volume":"5","author":"Hasani","year":"2008","journal-title":"Chron. Respir. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2226","DOI":"10.1007\/s00134-020-06312-y","article-title":"The role for high flow nasal cannula as a respiratory support strategy in adults: A clinical practice guideline","volume":"46","author":"Rochwerg","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2101574","DOI":"10.1183\/13993003.01574-2021","article-title":"ERS clinical practice guidelines: High-flow nasal cannula in acute respiratory failure","volume":"59","author":"Oczkowski","year":"2022","journal-title":"Eur. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1136\/thoraxjnl-2022-218806","article-title":"High-flow nasal oxygen versus conventional oxygen therapy in patients with COVID-19 pneumonia and mild hypoxaemia: A randomised controlled trial","volume":"78","author":"Crimi","year":"2023","journal-title":"Thorax"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s13613-024-01367-2","article-title":"Oxygen therapy in acute hypoxemic respiratory failure: Guidelines from the SRLF-SFMU consensus conference","volume":"14","author":"Helms","year":"2024","journal-title":"Ann. Intensive Care."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1080\/15412555.2020.1728736","article-title":"High Flow Nasal Therapy Use in Patients with Acute Exacerbation of COPD and Bronchiectasis: A Feasibility Study","volume":"17","author":"Crimi","year":"2020","journal-title":"COPD J. Chronic Obstr. Pulm. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1164\/rccm.201605-0916OC","article-title":"Physiologic Effects of High-Flow Nasal Cannula in Acute Hypoxemic Respiratory Failure","volume":"195","author":"Mauri","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1007\/s00134-024-07386-8","article-title":"High-flow nasal cannula: Evolving practices and novel clinical and physiological insights","volume":"50","author":"Roca","year":"2024","journal-title":"Intensive Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/s13054-019-2473-y","article-title":"Effect of high-flow nasal therapy on dyspnea, comfort, and respiratory rate","volume":"23","author":"Cortegiani","year":"2019","journal-title":"Crit. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.2147\/COPD.S159666","article-title":"Long-term effects of oxygen-enriched high-flow nasal cannula treatment in COPD patients with chronic hypoxemic respiratory failure","volume":"13","author":"Storgaard","year":"2018","journal-title":"Int. J. Chron. Obstruct Pulmon Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1513\/AnnalsATS.201706-425OC","article-title":"Domiciliary High-Flow Nasal Cannula Oxygen Therapy for Patients with Stable Hypercapnic Chronic Obstructive Pulmonary Disease. A Multicenter Randomized Crossover Trial","volume":"15","author":"Nagata","year":"2018","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1164\/rccm.202201-0199OC","article-title":"Home High-Flow Nasal Cannula Oxygen Therapy for Stable Hypercapnic COPD: A Randomized Clinical Trial","volume":"206","author":"Nagata","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.rmed.2009.12.016","article-title":"The clinical utility of long-term humidification therapy in chronic airway disease","volume":"104","author":"Rea","year":"2010","journal-title":"Respir. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"00711-2020","DOI":"10.1183\/23120541.00711-2020","article-title":"The role of high-flow nasal therapy in bronchiectasis: A post hoc analysis","volume":"7","author":"Good","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Crimi, C., Nolasco, S., Campisi, R., Nigro, M., Impellizzeri, P., Cortegiani, A., Noto, A., Gramegna, A., Vancheri, C., and Blasi, F. (2022). Long-Term Domiciliary High-Flow Nasal Therapy in Patients with Bronchiectasis: A Preliminary Retrospective Observational Case-Control Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11247323"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2178600","DOI":"10.1080\/20018525.2023.2178600","article-title":"The Danish respiratory society guideline for long-term high flow nasal cannula treatment, with or without supplementary oxygen","volume":"10","author":"Weinreich","year":"2023","journal-title":"Eur. Clin. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Simioli, F., Fiorentino, G., Cauteruccio, R., Coppola, A., Imitazione, P., Marotta, A., Di Spirito, V., and Annunziata, A. (2023). Long-Term High Flow Nasal Cannula Therapy in Primary and Secondary Bronchiectasis. Healthcare, 11.","DOI":"10.3390\/healthcare11091250"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1164\/rccm.201309-1575OC","article-title":"The bronchiectasis severity index. An international derivation and validation study","volume":"189","author":"Chalmers","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1700629","DOI":"10.1183\/13993003.00629-2017","article-title":"European Respiratory Society guidelines for the management of adult bronchiectasis","volume":"50","author":"Polverino","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_30","first-page":"227","article-title":"Multicollinearity in Regression Analyses Conducted in Epidemiologic Studies","volume":"6","author":"Vatcheva","year":"2016","journal-title":"Epidemiology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.arbr.2013.08.001","article-title":"Presence of anxiety and depression in patients with bronchiectasis unrelated to cystic fibrosis","volume":"49","author":"Cisneros","year":"2013","journal-title":"Arch. Bronconeumol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1378\/chest.07-0490","article-title":"Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis","volume":"132","author":"Soriano","year":"2007","journal-title":"Chest"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.rmed.2009.11.021","article-title":"Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis","volume":"104","author":"Finklea","year":"2010","journal-title":"Respir. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.arbres.2022.04.008","article-title":"Factors Associated With One-Year Mortality in Hospitalised Patients With Exacerbated Bronchiectasis","volume":"58","author":"Scioscia","year":"2022","journal-title":"Arch. Bronconeumol."},{"key":"ref_35","first-page":"1602","article-title":"A Comprehensive Analysis of the Impact of Pseudomonas aeruginosa Colonization on Prognosis in Adult Bronchiectasis","volume":"12","author":"Finch","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1701953","DOI":"10.1183\/13993003.01953-2017","article-title":"The independent contribution of Pseudomonas aeruginosa infection to long-term clinical outcomes in bronchiectasis","volume":"51","author":"Shteinberg","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14799731221137085","DOI":"10.1177\/14799731221137085","article-title":"The effect of domiciliary high flow nasal cannula treatment on dyspnea and walking distance in patients with interstitial lung disease\u2014A pilot study","volume":"19","author":"Weinreich","year":"2022","journal-title":"Chron. Respir. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.arbres.2024.05.001","article-title":"Effectiveness, Adherence and Safety of Home High Flow Nasal Cannula in Chronic Respiratory Disease and Respiratory Insufficiency: A Systematic Review","volume":"60","author":"Correia","year":"2024","journal-title":"Arch. Bronconeumol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"11805","DOI":"10.4187\/respcare.11805","article-title":"Home respiratory strategies in COPD patients with chronic hypercapnic respiratory failure: A systematic review and network meta-analysis","volume":"69","author":"Pitre","year":"2024","journal-title":"Respir. Care."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"00507-2021","DOI":"10.1183\/23120541.00507-2021","article-title":"Bronchiectasis: Moving from an orphan disease to an unpleasant socioeconomic burden","volume":"7","author":"Athanazio","year":"2021","journal-title":"ERJ Open Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/20\/6146\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:13:53Z","timestamp":1760112833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/20\/6146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,15]]},"references-count":40,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["jcm13206146"],"URL":"https:\/\/doi.org\/10.3390\/jcm13206146","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,15]]}}}