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JOURNAL ARTICLE

High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure

Myoung Kyu Lee, Jaehwa Choi, Bonil Park, Bumjoon Kim, Seok Jeong Lee, Sang-Ha Kim, Suk Joong Yong, Eun Hee Choi, Won-Yeon Lee
Clinical Respiratory Journal 2018 February 2
29392846

INTRODUCTION: Severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a significant event that results in substantial mortality.

OBJECTIVES: We evaluated the effectiveness of the high flow nasal cannulae (HFNC) therapy in severe AECOPD with moderate hypercapnic acute respiratory failure (ARF) compared to non-invasive ventilation (NIV).

METHODS: The prospective observational trial was performed to compare the effectiveness between the HFNC and NIV in severe AECOPD with moderate hypercapnic ARF. The end point was the intubation rate and 30-day mortality.

RESULTS: Ninety-two AECOPD patients enrolled during study periods. The median age was 73 (66.5-79) year-old and 57 patients (64.8%) were male. Forty-four patients were assigned to HFNC and 44 patients to NIV. The intubation rate at day 30 was 25.0% in HFNC group and 27.3% in NIV group (P = 0.857) and the 30-day mortality was 15.9% in HFNC group and 18.2% in NIV group (P = 0.845). The pH (7.38 ± 0.59 vs. 7.36 ± 0.10, P = 0.295), PaO2 (82.2 ± 24.9 vs. 81.6 ± 21.7 mmHg, P = 0.899) and PaCO2 (46.8 ± 15.2 vs. 51.7 ± 17.2 mmHg, P = 0.160) after 6 hours and the pH (7.39 ± 0.07 vs. 7.39 ± 0.08, P = 0.743), PaO2 (84.3 ± 18.5 vs. 84.7 ± 23.2 mmHg, P = 0.934) and PaCO2 (47.0 ± 16.0 vs. 49.6 ± 13.7 mmHg, P = 0.422) after 24 hours were not significantly different.

CONCLUSION: There was no difference of the 30-day mortality and intubation rate between HFNC and NIV groups. This article is protected by copyright. All rights reserved.

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