Zhongguo linchuang yanjiu (Feb 2024)

Application of high flow nasal cannula oxygen therapy in elderly patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure

  • WANG Jing, TANG Na

DOI
https://doi.org/10.13429/j.cnki.cjcr.2024.02.015
Journal volume & issue
Vol. 37, no. 2
pp. 242 – 245

Abstract

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Objective To investigate the therapeutic effect of high flow nasal cannula oxygen therapy (HFNC) on elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type Ⅱ respiratory failure. Methods A total of 96 elderly AECOPD patients with type 2 respiratory failure who received treatment at Xuanwu Hospital Capital Medical University from January to December 2022 were selected and divided into observation group ( n=49) and control group ( n=47) randomly. On the basis of conventional anti-inflammatory and antiasthmatic treatment, control group was treated with non-invasive positive pressure ventilation (NPPV), observation group was treated with HFNC. The level of pH value, arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) before and after treatment were compared between two groups. The treatment comfort was evaluated with questionnaires. After 28 days of follow-up, the incidence of complications such as aspiration, bloating, tracheal intubation rate and mortality rate were compared between two groups. Results After treatment, pH value and PaO2 increased, and PaCO2 decreased in both group (P＜0.05). However, there was no significant difference in pH, PaO2 and PaCO2 between two groups after treatment (P＞0.05). The score of comfort degree of the observation group was higher than that of the control group (3.57±0.71 vs 2.46±0.83, t=7.020，P＜0.01), and the complication rate was lower than that of the control group (10.20% vs 27.65%, χ2=4.798，P＜0.05). There was no significant difference between the two groups in the tracheal intubation rate and mortality rate (P＞0.05). Conclusion NPPV and HFNC have similar therapeutic effect in elderly AECOPD patients with type 2 respiratory failure, but HFNC has fewer complications and higher degree of comfort.

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