Topical Nasal Moisturization for Oxygen-Related Nasal Dryness During Low-Flow Oxygen Therapy

Conventional low-flow oxygen therapy delivered through a nasal cannula can cause nasal dryness and discomfort. This study evaluated whether topical nasal moisturization with 0.9% isotonic saline nasal drops or a hyaluronic acid-based nasal spray could reduce nasal dryness in adults receiving low-flow oxygen therapy. In this prospective, randomized, three-arm clinical trial, 150 adults receiving conventional low-flow nasal oxygen therapy in a coronary intensive care unit were assigned to one of three groups: low-flow oxygen alone, low-flow oxygen plus 0.9% isotonic saline nasal drops, or low-flow oxygen plus a hyaluronic acid-based nasal spray. All participants received low-flow oxygen alone during the first 4 hours. After the 4-hour assessment, the assigned topical nasal interventions were started and continued until the 12-hour assessment. The primary outcome was patient-reported nasal dryness. Other assessments included patient comfort, nasal pain, clinician-assessed nasal mucosal dryness, nasal moisture measured using the intranasal Schirmer test, and epistaxis. Outcomes were assessed at 4 and 12 hours.