Application of High Flow Nasal Cannulae Combined with Sequential Noninvasive Ventilation in the Initial Ventilation Strategy of AECOPD
Objective:To explore the efficacy and safety of high flow nasal cannulae(HFNC)combined with sequential noninvasive ventilation(NIV)versus NIV alone as the initial ventilation strategy for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:Fifty-eight AECOPD patients admitted to Shangrao Municipal Hospital from January to April 2024 were selected as the research subjects and randomly divided into an intervention group and a conventional group,with 29 cases in each group.The intervention group received HFNC combined with sequential NIV treatment,while the conventional group received NIV treatment alone.The clinical indicators,changes in arterial carbon dioxide partial pressure(PaCO2)levels,modified British medical research council(mMRC)dyspnea questionnaire for respiratory difficulties grades,and complication rates were compared between the two groups.Result:The length of hospital stay and total respiratory support time in the intervention group were shorter than those in the conventional group,and the failure rate of NIV treatment was lower than that in the conventional group,the differences were statistically significant(P<0.05).At 6,12 and 18 h after treatment,PaCO2 levels in the intervention group were lower than those in the conventional group,the differences were statistically significant(P<0.05).At 12,18 and 24 h after the treatment,the mMRC grading in intervention group were lower than those of the conventional group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the intervention group was 10.34%,which was lower than 34.48%in the conventional group,the difference was statistically significant(P<0.05).Conclusion:HFNC combined with sequential NIV as the initial ventilation strategy for AECOPD,compared with NIV alone,can effectively shorten hospital stay,reduce treatment failure rate,improve PaCO2 level and dyspnea symptoms,and have a lower incidence of adverse reactions.
万方数据
维普
