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© 2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Introduction: Currently, there is a lack of evidence on the utilization of high-flow nasal cannula (HFNC) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) accompanied by hypercapnic respiratory failure. We aimed to explore the efficacy and safety of HFNC compared with conventional oxygen therapy (COT) in such patients.

Methods: This was a prospective, randomized, controlled trial. Patients with AECOPD with a baseline arterial blood gas pH ≥ 7.35, PaO2 < 60 mmHg, and PaCO2 > 45 mmHg were enrolled. The primary endpoint was treatment failure, which needs mechanical ventilation.

Results: A total of 320 patients were randomized to either the HFNC group (n = 160) or the COT group (n = 160). Sixteen (10.0%) patients in the HFNC group had treatment failure during hospitalization, which was significantly lower than the COT group figure of 31 (19.4%) patients (p = 0.026). Twenty-four hours after recruitment, the PaCO2 of the HFNC group was lower than that of the COT group (54.1 ± 9.79 mmHg vs 56.9 ± 10.1 mmHg, p = 0.030). PaCO2 higher than 59 mmHg after HFNC for 24 h was identified as an independent risk factor for treatment failure [OR 1.078, 95% CI 1.006– 1.154, p = 0.032].

Conclusion: In AECOPD patients with acute compensated hypercapnic respiratory failure, HFNC improved the prognosis compared with COT. Therefore, HFNC might be considered for first-line oxygen therapy in select patients.

Trial Registration Number: ClinicalTrials.Gov: NCT02439333.

Details

Title
High-Flow Nasal Cannula for Chronic Obstructive Pulmonary Disease with Acute Compensated Hypercapnic Respiratory Failure: A Randomized, Controlled Trial
Author
Li, X Y; Tang, X  VIAFID ORCID Logo  ; Wang, R; Yuan, X; Zhao, Y; Wang, L; Li, H C; Chu, H W; Li J; Mao, W P; Wang, Y J; Tian, Z H; Liu, J H; Luo, Q; Sun, B; Tong, Z H
Pages
3051-3061
Section
Original Research
Publication year
2020
Publication date
2020
Publisher
Dove Medical Press Ltd.
ISSN
11769106
e-ISSN
11782005
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2679513657
Copyright
© 2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.