Comparison Of Nasal High Flow Humidified Oxygen Therapy And Non-Invasive Positive Pressure Ventilation In Patients With AECOPD Ⅱ Respiratory Failure Complicated With Respiratory Muscle Fatigue

Objective:To compare the efficacy of high-flow nasal cannula oxygen therapy（HFNC）and non-invasive positive pressure ventilation（NPPV）in the treatment of AECOPD typeⅡrespiratory failure complicated with respiratory muscle fatigue.Methods:90 inpatients with AECOPDⅡrespiratory failure were divided into mild respiratory muscle fatigue group（n=46）and severe respiratory muscle fatigue group（n=44）according to the score of auxiliary respiratory muscle use.The two groups were randomly divided into HFNC treatment group（24 cases in mild respiratory muscle fatigue group and 22 cases in severe respiratory muscle fatigue group）,NPPV treatment group（There were 19 cases in mild respiratory muscle fatigue group and 25 cases in severe respiratory muscle fatigue group）.The PO₂,PCO₂,auxiliary respiratory muscle score before treatment,24 hours after treatment and 48 hours after treatment;diaphragmatic muscles mobility before treatment and 48 hours after treatment;the difference of tracheal intubation rate and group change rate among the four groups.Results:The PO₂,PCO₂and diaphragmatic muscles mobility were improved compared with those before treatment（P<0.05）,and there was no significant difference between mild respiratory muscle fatigue group at the same time point;In the two groups with severe respiratory muscle fatigue,the improvement in NPPV group was more obvious than that in HFNC group（P<0.05）.The score of auxiliary respiratory muscle utilization after 24hours and 48 hours of treatment was no difference between the two groups with mild respiratory muscle fatigue and HFNC severe respiratory muscle fatigue group before treatment,but the score in NPPV severe respiratory muscle fatigue group was better than that before treatment（P<0.05）;After 24 hours of treatment,the scores of severe respiratory muscle fatigue of NPPV group were significantly better than those of HFNC group.（P<0.05）;There was significant difference in tracheal intubation rate between the severe respiratory muscle fatigue groups（P<0.05）.There was no significant difference in group switching rate among the four groups.Conclusion:HFNC is similar to NPPV in the treatment of AECOPD type II respiratory failure patients with mild respiratory muscle fatigue;NPPV is superior to HFNC in the treatment of patients with severe respiratory muscle fatigue.