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| Randomized controlled study of HFNC and NPPV in the treatment of AECOPD combined with type Ⅱ respiratory failure |
| Wang Jian-jun, Jiang Hong-ying, Li Qing |
| Department of Respiratory and Critical Care Medicine, Beijing Rehabilitation Hospital, Capital University of Medical Sciences, Beijing 100144, China |
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Abstract Objective To investigate the efficacy and safety of HFNC in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with type II respiratory failure. Methods A prospective study was performed in the research. Sixty-three patients with AECOPD combined with type II respiratory failure were randomly divided into HFNC group and NPPV group with 32 cases in HFNC group and 31 cases in NPPV group. HFNC group was given with high flow humidified oxygen through nose, NPPV group was treated with non-invasive ventilation. Two groups of patients changed to another mode of respiratory support for various reasons or invasive mechanical ventilation through endotracheal intubation was defined as failure after enrollment. The failure rate, tracheal intubation rate, complications and 28-day survival rate were observed. Results The failure rate of HFNC group (21.9%) was lower than that of NPPV group (29.0%). There was no significant difference (P=0.572). There were 6 patients (18.8%) with tracheal intubation in HFNC group and 7 patients (22.6%) in NPPV group. There was no significant difference (P=0.763). The nasal and facial injuries in HFNC group (9.4%) were less than those in NPPV group (35.5%). The difference was significant (P=0.016). Gastric and intestinal flatulence in HFNC group (18.8%) was less than that in NPPV group (48.4%). The difference was statistically significant (P=0.017).The duration of high flow oxygen therapy through nose in HFNC group (8.63±1.41)d was longer than that of non-invasive ventilation in NPPV group (7.48±1.12)d, and the difference was statistically significant (P=0.001). The relief time of dyspnea (8.25±1.61)h was shorter than that of NPPV group (5.77±1.28)h, and the difference was statistically significant (P=0.000). There was no significant difference in ICU time (P=0.569) and total hospital stay (P=0.122) between the two groups. The 28-day mortality in HFNC group was 25%, which was not significantly different from that in NPPV group (19.4%). Conclusion HFNC is effective and safe in the treatment of AECOPD patients with type II respiratory failure.
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| About author:: Wang Jian-jun, E-mail: wjj999315@163.com |
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