Analysis of the Effects of Humidified High Flow Nasal Oxygen Therapy Combined with Noninvasive Mechanical Ventilation on Treatment Outcomes.

Abstract

Objective To investigate the effects of humidified high flow nasal cannula (HFNC) oxygen therapy combined with noninvasive mechanical ventilation (NIV) on blood gas indexes, complications, and respiratory function in patients with AECOPD. Method 100 patients with AECOPD admitted to the Department of Respiratory and Critical Medicine of Pukou District Central Hospital of Nanjing from March 2020 to February 2021 were selected. The patients were randomly divided into study group (50 cases) and control group (50 cases); both groups were given routine treatment such as bronchodilators, low-dose glucocorticoids, and antibiotics. During the treatment, the vital signs, inflammatory response indexes, fluid balance, and nutrition were continuously monitored; the body position was changed every 2 hours; and the curative effect was evaluated one week after treatment. On this basis, the control group received routine oxygen therapy combined with NIV (low flow conventional oxygen therapy + NIV), and the study group received HFNC combined with NIV (HFNC + NIV). The oxygen partial pressure (PaO2), peak expiratory flow rate (PEFR), arterial oxygen saturation (SaO2), first-second forced expiratory volume (FEV1), and mixed venous oxygen saturation (SvO2) level were compared between the two groups before and after treatment. Moreover, SECS scores before ventilation and 2, 4, 6, and 12 hours after ventilation were collected and analyzed. In addition, complications during oxygen therapy were compared. Result Before treatment, there was no significant difference in the levels of PaCO2, FEV1, SaO2, PEFR, and SvO2 between the two groups (P > 0.05). After treatment, the levels of PaCO2 in the study group were lower than those in the control group, and the levels of FEV1, SaO2, PEFR, and SvO2 in the study group were higher than those in the control group P < 0.05(P < 0.05). There was no significant difference in SECS scores between the two groups before ventilation and 2 hours after ventilation (P > 0.05). The SECS scores of the study group at 4, 6, and 12 hours after ventilation were higher than those of the control group P < 0.05(P < 0.05). The total complication rate in the study group (8.00% vs. 24.00%) was lower than that in the control group (P < 0.05). Compared with low flow conventional oxygen therapy, NIV combined with HFNC can effectively reduce the incidence of complications in AECOPD patients during oxygen therapy, improve patients' ventilation comfort, and effectively improve blood gas indexes and respiratory function, with simple operation and high safety, which is worthy of clinical promotion and application.