| Objective: To compare the efficacy of sequential nasal high flow oxygen therapy and non-invasive positive pressure ventilation in patients with COPD with respiratory failure.Methods: Sixty patients with COPD combined with respiratory failure,hospitalized in the Department of Respiratory and Critical Care Medicine from January2021 to June 2022,were selected,and all of them met the diagnostic criteria set by the2020 GOLD guidelines.In the transnasal high flow oxygen therapy group,30 patients,20 men,10 women,mean age(67.76 ± 7.25),mean BMI(21.65 ± 3.16)kg/m2,30 patients in the noninvasive positive pressure ventilation group,19 men,11 women,mean age(69.38 ± 8.67),BMI(23.67 ± 3.02)kg / m2.Two groups were compared with sputum viscosity,sputum difficulty score,cough symptom score table,respiratory level,blood gas analysis index(pH value,PaO 2,PaCO2 value),complication rate,days of ICU stay,total response rate,etc.Results: The sputum viscosity,sputum difficulty and cough symptoms HFNC group were higher than the NIPPV group(P <0.05).Brog was significantly higher than in the NIPPV group(P <0.05).Prior to treatment,there were no significant differences in pH,PaCO2,and PaO 2 values between the HFNC and NIPPV groups(P> 0.05);pH and PaO 2 were higher 24 and 48 hours after treatment,decreased at PaCO2,PH,PaO 2,PaCO2,and PaO 2 / FiO 2 were significant(P <0.05),while the NIPPV group was significantly better than the HFNC group.The number of days in the NIPPV ICU(12.36± 1.21)was shorter than the HFNC group(15.26 ± 1.24),with a significant difference(t=10.848,P <0.05).The incidence of NIPPV and HFNC intubation was 3.3% and16.7%,respectively.The length of hospitalization and reintubation rate were significantly higher in the HFNC group than in the NIPPV group.The total response rate was higher in NIPV group than HFNC group,statistically significant(t=9.458,P=0.002 <0.05).Conclusion: This paper also compares HFNC and NIPPV for blood gases,dyspnea,length of stay,and intubation rate in patients with AECOPD failure.The results of this study showed that NIPPV outperformed HFNC in improving oxygenation,reducing CO2 storage,reducing endotracheal intubation rate,HFNC than NIPPV in reducing sputum viscosity,sputum difficulty,cough symptoms,and reducing dyspnea,and HFNC can replace NIPPV in patients with sputum viscosity AECOPD and respiratory failure.Moreover,the results showed that the treatment failure rate within 7 days after withdrawal in HFNC patients was significantly higher than that in NIPPV.Metaanalysis showed that NIPPV was more effective than HFNC in reducing the incidence of withdrawal failure from 48 h to 1 week.Therefore,this study shows that the use of NIPPV is more effective than HFNC in supporting the effectiveness of sequential treatment in COPD patients with respiratory failure. |
