Usefulness of Telemonitoring in Respiratory Deterioration in a Patient Treated With Home High-Flow Nasal Therapy

A 63-year-old male with overlap syndrome had high-flow nasal cannula (HFNC) therapy added to his treatment in May 2023 after reporting reduced exercise tolerance due to dyspnea and recurrence of chronic bronchial congestion on existing therapy (noninvasive ventilation and appropriate drug treatment). HFNC therapy (Lumis HFT; ResMed) was started with prescribed usage of 2 h/day, a flow of 20 L/min, and a temperature of 37°C. Within 15 days, the patient noted improved clearance with thinner secretions, and then secretion volume decreased after 2 months. Six months after having HFNC connected to a telemonitoring platform (AirView), the homecare technician observed a sudden increase in HFNC usage (to > 4 h/day). After being contacted by the technician, the patient reported increased sputum production, low-grade fever, and exertional dyspnea. Evaluations found Haemophilus influenzae, and antibiotic therapy was started. The patient quickly improved and HFNC usage returned to the usual routine. Subsequently, the patient learned to adjust his HFNC usage based on the degree of bronchial congestion. This case report highlights the innovative value of telemonitoring as an early warning tool for exacerbations in patients receiving home high-flow nasal therapy, an aspect still scarcely documented in existing literature.