Randomized controlled study on sequential treatment of different respira-tory support modes after extubation in acute exacerbation of chronic ob-structive pulmonary disease
Objective To investigate the clinical effect of sequential treatment with different respiratory support after extu-bation in acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods From January 2021 to March 2023,48 acute exacerbation of COPD(AECOPD)patients with hypercapnia who were treated with invasive ventilation in Affiliated Hospital of Jiujiang University were selected as the study objects,after meeting the criteria for extubation,they were divided into non-invasive mechanical ventilation(NIV)group and high-flow nasal cannula oxygen therapy(HFNC)group according to the random number table method,24 cases in each group.Blood gas analysis indexes,mean arterial pressure,heart rate,respiratory rate,comfort level,reintubation rate and tracheoscopy sputum aspiration were compared between the two groups before and after extubation.Results There were no statistical differences in pH values,PO2,PCO2,and PaO2/FiO2 between HFNC group and NIV groups with in 6,12,24 h after extubation(P＞0.05).The respiratory rate,heart rate and mean arteri-al pressure within 6,12,24 h after extubation in HFNC group and NIV group were not significantly different(P＞0.05).The comfort score in HFNC group was higher than that in NIV group,and the total incidence of adverse event was lower than that of NIV group,the difference were statistically significant(P＜0.05).The re-intubation rate and required bronchoscopic treatment rate were not statistically different between the two groups(P＞0.05).Conclusion Among COPD patients with se-vere hypercapnic respiratory failure who received invasive ventilation,the use of HFNC after extubation does not result in increased rates of treatment failure compared with NIV.HFNC also has better tolerance and comfort than NIV.
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