THE EFFECTIVENESS OF HIGH FLOW OXYGEN THERAPY AND NONINVASIVE MECHANICAL VENTILATION TREATMENT IN ACUTE RESPIRATORY FAILURE DUE TO CHRONIC OBSTRUCTIVE PULMONARY DISEASE - A RANDOMIZED STUDY.

Hypercapnic acute respiratory failure (ARF) is a common complication of chronic obstructive pulmonary disease (COPD). Respiratory support is required in ARF, which usually has a high mortality risk. The objective was to compare the effectiveness of noninvasive mechanical ventilation (NIV), which is the traditional treatment protocol for COPD, with high-flow nasal cannula oxygen therapy (HFNT) as an emerging treatment method. This study was performed between August 20, 2019 and December 20, 2019, as a prospective randomized controlled study. Patients who were admitted with ARF due to COPD were included in the study. With randomization, 30 patients were treated with HFNT, whereas 31 patients were treated with NIV. The pH value of the HFNT group was significantly higher at the 1st hour of treatment (p=0.001). While there were no significant differences in subsequent pH values in the HFNT group (p=0.130), the pH value in the NIV group was found to have changed significantly (p=0.030). Compared to the NIV group, the 1st hour PaCO2 value in the HFNT group was significantly higher (p<0.001). The PaCO2 value decreased and PaO2 value increased significantly during follow-up in both groups (p<0.001). There were no significant differences in intra-group lactate and HCO3 values in the HFNT group, whereas the corresponding changes in the NIV group were significant (p=0.002). Compared to the HFNT group, the NIV group length of stay in the intensive care unit (ICU) was significantly longer (p=0.039). The use of HFNT, especially in more serious COPD patients, can be described as an intervention that could be beneficial in the acute period and could reduce the frequency of nosocomial infections by shortening ICU stay.