Comparison Of The Effects Of HFNC And NIPPV In Treating AECOPD Combined With Type ? Respiratory Failure

Comparison of the effects of high flow nasal cannula andnon-invasive positive pressure ventilation in treating acuteexacerbation of chronic obstructive pulmonary disease combinedwith type ? respiratory failure.Objective:Acute Exacerbation of Chronic Obstructive Pulmonary Disease?AECOPD?is a common and frequently-occurring disease in the clinic,with a high mortality rate,which seriously harms human health.AECOPD combined with type?respiratory failure is an important factor leading to the increased mortality of the disease.In addition to clinical anti-infection,diastolic airway,cough suppression and expectoration,correction of acid-base imbalance,correction of water and electrolyte disorders,assisted ventilation should be actively given to improve patient oxygenation,reduce carbon dioxide retention and correct respiratory failure.This study intended to compare the clinical effects of high flow nasal cannula?HFNC?and non-invasive positive pressure ventilation?NIPPV?in AECOPD combined with type?respiratory failure to analyze nasal high flow oxygen Clinical value of AECOPD combined with type?respiratory failure,so as to provide a new non-invasive ventilation mode for clinicians to treat AECOPD combined with type?respiratory failure.Methods:A retrospective analysis of 156 patients with AECOPD combined with type?respiratory failure who were admitted to the Department of Respiratory and Critical Care Medicine in the Second Department of the First Hospital of Jilin University from January 2019 to December 2019.90 patients were excluded and 66 patients were enrolled.All patients met the following exclusion criteria:?1?Severe hypercapnia?PaCO₂?75mmHg?at the time of admission;?2?Patients undergoing endotracheal intubation or tracheostomy within 24 hours after admission;?3?Patients with impaired consciousness or mental illness;?4?Patients with severe heart dysfunction,liver and kidney dysfunction;?5?Patients with asthma,tuberculosis,interstitial lung disease,thoracic deformity,malignant tumor,and myasthenia gravis;?6?Patients with recent surgery,trauma,severe infections;?7?Interruption of assisted ventilation therapy;?8?Non-cooperative blood draw monitoring experiment index.Among them,32 patients were treated with HFNC as the HFNC group,and 34 patients were treated with NIPPV as the NIPPV group.Both groups were given conventional anti-infection,asthma,cough suppression and expectorant,nutritional support and other treatments.We compared the arterial blood pH,arterial blood oxygen partial pressure?PaO₂?,arterial blood carbon dioxide partial pressure?PaCO₂?,blood oxygen saturation?SpO₂?,oxygenation index?PaO₂/FiO₂?,breathing rate?RR?and heart rate?HR?before and after treatment 2h,6h,24h and 72h.We also compared the incidence of nasal and facial skin damage,number of airway care interventions within 24 hours after treatment,treatment failure rate?replacement of ventilation device or tracheal intubation midway?,mortality rate,total hospital stay Ventilation treatment time,ventilation treatment cost and other indicators and analyzed the treatment effects as well as the situation of disease conversion between the two groups.Result:1.We compared the gender,age,course of disease,smoking history,body mass index,pulmonary function level,drugs inhaled in the stable phase,and pH before treatment,PaCO₂,PaO₂ in the HFNC group and NIPPV group.,SpO₂,PaO₂/FiO₂,RR,HR and other indicators,there is no statistically significant difference between the two groups?P>0.05?,and they are comparable.2.We compared the pH,PaCO₂,PaO₂,SpO₂,PaO₂/FiO₂,RR,HR and other indicators of patients in the HFNC group and NIPPV group at 2h,6h,24h,and 72h after treatment.There was no significant difference between the groups?P>0.05?.3.The ventilation treatment time,ventilation treatment cost,total hospitalization time,and mortality were compared between the HFNC group and the NIPPV group.There was no significant difference in ventilation treatment time,total hospitalization time,and mortality between the two groups?P>0.05?;But there was a significant difference in the cost of ventilation treatment?P<0.05?.4.The incidence of nasal and facial skin damage,the number of airway nursing interventions within 24 hours after treatment,and the rate of treatment failure were compared between the HFNC group and the NIPPV group.The date of HFNC group were significantly lower than that of NIPPV group,and the difference was statistically significant?P<0.05?.Conclusion:1.For patients with AECOPD combined with type?respiratory failure?PaCO2?75mmHg,under low-flow oxygen inhalation?,HFNC treatment and NIPPV treatment were similar in terms of improvement in clinical indicators?such as PH,PaCO₂,PaO₂,SpO₂,PaO₂/FiO₂,RR,HR?,ventilation time,total hospitalization time,and mortality.2.AECOPD in patients with type ? respiratory failure?PaCO₂?75mmHg,under low-flow oxygen inhalation?,the incidence of nasal and facial skin damage in the HFNC group,the number of airway care interventions within 24hours after treatment,the treatment failure rate,and the ventilation cost less than NIPPV group.3.HFNC has the advantages of less damage,good tolerance,and low cost.It can be used as the first choice for patients with AECOPD combined with type?respiratory failure?PaCO₂?75mmHg,under low-flow oxygen inhalation?.