The efficacy of high-flow nasal cannulae oxygen therapy in severe acute exacerbation of chronic obstructive pulmonary disease: A randomized controlled trial

Abstract

High flow nasal cannulae (HFNC) oxygen therapy has demonstrated an effect comparable with non-invasive ventilation (NIV). We conducted the prospective randomized controlled study to compare the effectiveness between the HFNC and NIV in severe AECOPD with moderate hypercapnic acute respiratory failure. We enrolled the patients who hospitalized with severe AECOPD from January 2013 to February 2015. Each group of eligible patients received HFNC or NIV oxygen therapy respectively. The primary end point was the 30-day mortality. Treatment failure was defined that the patients underwent intubation with mechanical ventilation due to continuous hypoxia and hypercapnia despite of HFNC or NIV. Finally 68 patients underwent randomization. The mean age was 72.4 ± 9.5 years. The 30-day mortality was 22.2% on HFNC and 28.1% on NIV group, and treatment failure was 33.3% on HFNC and 50.0% on NIV groups, respectively. Hypercapnia was more improved in HFNC oxygen therapy group than NIV group in severe AECOPD with respiratory failure HFNC oxygen therapy may be alternative to NIV therapy in severe AECOPD.