Comparison between nasal high-flow oxygen therapy and noninvasive ventilation on the outcome of patients with chronic interstitial lung disease complicated with acute respiratory failure

Abstract

Background Interstitial lung disease (ILD) is a wide range of illnesses that damage the lung parenchyma and have varying etiologies, clinical presentations, radiographic patterns, and histological appearances. The common characteristic is the occurrence of inflammatory and fibrous changes. This work aimed to compare the clinical outcome of high-flow nasal oxygen therapy and noninvasive ventilation in patients presenting with acute exacerbation of chronic interstitial lung disease. Materials and Methods This prospective, randomized work was performed on 40 individuals with acute exacerbation of ILD. Participants were categorized into two equal groups: Group1 were treated with high-flow nasal oxygen therapy (HFNOT), aged from 27–82 years. Group 2 were treated with noninvasive ventilation (NIV), aged from 40 to 80 years. Results A substantial negative association existed among the HACOR score and ROX index as a low HACOR score and a high ROX index is predicting for success and vice versa. Mortality rate and survival are equal in both groups but HFNOT is more comfortable and better tolerated than NIV, and is also expected to maintain a better quality of life because it easily allows food intake and conversations. Conclusion HFNOT is considered to be the first noninvasive option as a noninvasive ventilator in individuals with acute exacerbation of ILD after the failure of conventional oxygen therapy with same efficacy, more tolerability, and less complication carrying the same mortality rate in comparison with NIV.

Keywords

• acute respiratory failure
• chronic interstitial lung disease
• nasal high-flow oxygen therapy
• noninvasive ventilation