Comparison of influence of non-invasive positive pressure ventilation and high-flow nasal cannula oxygen therapy on efficacy and prognosis in AECOPD patients

FU Xiaopei; TENG Xiaobao; HAN Mingfeng

doi:10.3639/j.issn.2095-3097.2024.11.011

Abstract：Objective To compare and explore the influence of non-invasive positive pressure ventilation(NIPPV)and high-flow nasal cannula(HFNC)oxygen therapy on the efficacy and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A retrospective analysis was performed on 105 patients with AECOPD in the hospital from April 2022 to Decemberl 2023.The patients were divided into HFNC group(n=43,HFNC oxygen therapy)and NIPPV group(n=44,NIPPV)by different treatment regimens.The clinical conditions,physiological indexes,blood gas re-lated indexes,immune indexes and biochemical indexes before and after treatment,complications and prognosis were compared between both groups.Results The frequency of airway nursing within 72 hours in HFNC group was significantly less than that in NIPPV group(P<0.05),and the tolerable respiratory support time within 72 hours and mechanical ventilation time were significantly longer(P<0.05).The sputum viscosity in HFNC group was significantly improved(P<0.05),but there was no significant difference in hospital stay between groups(P>0.05).After 72 hours of treatment,the heart rate(HR)and respiratory rate(RESP)in both groups were significantly reduced(P<0.05)while the SpO2 was significantly enhanced(P<0.05),and the blood gas pH and partial pressure of oxygen(PaO2)were significantly increased(P<0.05)while the partial pressure of carbon dioxide(PaCO2)was significantly decreased(P<0.05),but there were no statistical differences between the two groups(P>0.05).After 72 hours of treatment,CD3+CD4+,CD3+CD8+and CD4+/CD8+were risen in both groups(P<0.05),and serum amyloid A(SAA)and neutrophil-to-lymphocyte ratio(NLR)were significantly decreased(P<0.05),and there were significant dif-ferences between HFNC group and NIPPV group after 72 hours of treatment(P<0.05).The incidence rates of complications in HFNC group were significantly lower than those in NIPPV group(P<0.05),but there was no obvious differ-ence in the readmission rate within half a year between groups(P>0.05).Conclusion Compared with non-invasive positive pressure ventilation,high-flow nasal cannula oxygen therapy is more easily accepted by patients.This oxygen therapy technique can effectively enhance the immune level and reduce the incidence rates of adverse events.