Objective To study the therapeutic effect of high flow nasal cannula oxygen therapy (HFNC) compared to non-invasive positive pressure ventilation (NPPV) in acute heart failure patients (AHF) with type 1 respiratory failure. Methods A total of 94 elderly AHF patients with type 1 respiratory failure were randomly divided into the observation group (48 cases) and control group (46 cases) in the emergency department of Xuanwu Hospital of Capital Medical University from January 2022 to December 2022. Both 2 groups were treated with conventional vasodilation and diuresis; the control group was treated with NPPV, and the observation group was treated with HFNC. The changes of respiratory rate, heart rate, serum NT-proBNP, arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) were compared between the two groups before and after 24 h treatment. The differences of treatment comfort between the two groups were evaluated with questionnaires. After 28 days of follow-up, the differences between the two groups in the incidence of complications such as aspiration, bloating, tracheal intubation rate and mortality rate were compared. Result After treatment, the respiratory rate, heart rate and NT-proBNP of the 2 groups were significantly lower (all P< 0.05) with higher PaO2 (all P<0.05) and PaCO2 (all P<0.05). After treatment, the respiratory rate, heart rate, NT-proBNP PaO2 and PaCO2 in the observation group were (23.77±2.36) beats/min, (89.17±5.80) beats/min, [13631.00 (9997.25, 16328.00)] pg/ml, (66.87 ± 2.78) mmHg, and (37.06 ± 2.56) mmHg respectively; the corresponding indicators of the control group were (23.33±2.81) times/min, (87.69±5.02) times/min, [12517.00 (9836.75, 17742.00)] pg/ml, (67.74±2.67) mmHg and (37.07±1.93) mmHg respectively; there was no statistically significant difference between the two groups (all P>0.05). The questionnaire showed that the comfort score of the observation group was higher than that of the control group [(3.35±0.69) vs. (2.76±0.77), P=0.001] and the incidence of complications was lower than that in the control group (10.41％vs. 28.26％, P=0.028); but there was no statistically significant difference in the tracheal intubation rate (12.50％vs. 10.86％) and mortality rate (10.41％vs. 8.69％) between the two groups of patients (P>0.05). Conclusion The application of HFNC and NPPV in AHF patients with type I respiratory failure has good therapeutic effect, but the complications of HFNC were less and the patients'comfort was higher.
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