Efficacy of high-flow nasal cannula oxygen therapy combined with sequential non-invasive ventilation in patients with chronic obstructive pulmonary disease complicated with type II respiratory failure.

BACKGROUND

Chronic obstructive pulmonary disease (COPD) complicated with type II respiratory failure (hypercapnia + hypoxemia) is a major cause of hospitalization and death. Non-invasive ventilation (NIV) is standard but may cause discomfort; high-flow nasal cannula oxygen therapy (HFNC) offers advantages in comfort and oxygenation.

OBJECTIVES

To evaluate the efficacy of HFNC + sequential NIV versus NIV alone in AECOPD patients with type II respiratory failure.

METHODS

100 patients (Jan 2021-Jan 2024) were randomly assigned to control (NIV alone, n = 50) or study group (HFNC: 8 AM-10 PM; NIV: 10 PM-8 AM, n = 50). Pre- and post-treatment outcomes included arterial blood gases, pulmonary function, vital signs, SF-36 quality of life, and complications.

RESULTS

Post-treatment, the study group showed better pH (7.39 ± 0.04 vs 7.31 ± 0.04), PaCO₂ (61.41 ± 3.78 vs 68.67 ± 4.44 mmHg), PaO₂ (72.02 ± 4.78 vs 58.72 ± 4.14 mmHg), FEV₁ (1.20 ± 0.17 vs 0.93 ± 0.20 L), RR (16.94 ± 3.40 vs 20.38 ± 3.64 breaths/min), HR (81.66 ± 10.99 vs 96.36 ± 11.97 beats/min), and SF-36 bodily pain, social function, emotional role scores (all P < 0.05). Hospital stay (10.2 ± 2.1 vs 12.8 ± 2.5 days), intubation rate (4% vs 12%), and mortality (2% vs 8%) favored the study group.

CONCLUSION

HFNC + sequential NIV is more effective than NIV alone in improving gas exchange, pulmonary function, and quality of life, with better clinical outcomes and fewer adverse reactions, warranting clinical promotion.