Clinical effect observation of HFNC and NIPPV on patients with AECOPD complicated with type Ⅱ respiratory failure
Objective To explore the clinical effect of high-flow nasal cannula(HFNC)and non-invasive positive pressure ventilation(NIPPV)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with type Ⅱ respiratory failure.Methods A total of 146 patients with AECOPD admitted in the Department of Critical Care Medicine of Quanzhou First Hospital,Fujian Medical University from January 2021 to January 2023 were selected and were divided into NIPPV group(n=47),HFNC group(n=49)and conventional group(n=50).The NIPPV group was treated with NIPPV,the HFNC group was treated with HFNC,and the conventional treatment group was treated with conventional oxygen therapy and anti-infection therapy.The circulation indicators,blood gas analysis index,respiratory support time,airway nursing times and general comfort questionnaire(GCQ)score before and after treatment were compared among the three groups.Results Among the 146 patients,there were 76 males and 70 females,aged from56 to 77 years,with an average age of(66.2±5.3)years.The respiratory rate(RR)and HR of the three groups were lower at 2 h and 24 h after treatment compared with the pre-treatment results,and RR,HR in HFNC group were lower than those in NIPPV group and conventional group at 6 h and 24 h after treatment,and the differences were statistically significant(P<0.05).Compared with the results of pre-treatment,PaO2 was increased and PaCO2 was decreased in the three groups after seven days of treatment,PaO2 was higer and PaCO2 was lower in HFNC group compared with NIPPV group and conventional group after seven days of treatment,and the differences were statistically significant(P<0.05).The differences of respiratory support time and airway nursing times among the three groups were statistically significant(P<0.05),among which the respiratory support time in NIPPV group was shorter and the airway nursing times in HFNC group were lesser.Conclusions HFNC can improve some circulatory indicators and blood gas analysis results of AECOPD patients complicated with type Ⅱ respiratory failure,with better comfort but longer respiratory support time.
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