High-Flow Nasal Cannula for Chronic Obstructive Pulmonary Disease with Acute Compensated Hypercapnic Respiratory Failure: A Randomized, Controlled Trial

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 conventi...

Full description

Saved in:
Bibliographic Details
Published in:International journal of chronic obstructive pulmonary disease 2020-01, Vol.15, p.3051-3061
Main Authors: Li, Xu-Yan, Tang, Xiao, Wang, Rui, Yuan, Xue, Zhao, Yu, Wang, Li, Li, Hai-Chao, Chu, Hui-Wen, Li, Jie, Mao, Wen-Ping, Wang, Yu-Jun, Tian, Zhan-Hong, Liu, Jian-Hua, Luo, Qin, Sun, Bing, Tong, Zhao-Hui
Format: Article
Language:English
Subjects:
Analysis
Blood gases
Care and treatment
Chronic obstructive pulmonary disease
Hospitalization
Intubation
Lung diseases, Obstructive
Muscle fatigue
Original Research
Oxygen therapy
Patients
Regression analysis
Respiratory failure
Respiratory insufficiency
Statistical analysis
Variables
Variance analysis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. This was a prospective, randomized, controlled trial. Patients with AECOPD with a baseline arterial blood gas pH ≥7.35, PaO 45 mmHg were enrolled. The primary endpoint was treatment failure, which needs mechanical ventilation. 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 ( = 0.026). Twenty-four hours after recruitment, the PaCO of the HFNC group was lower than that of the COT group (54.1 ± 9.79 mmHg vs 56.9 ± 10.1 mmHg, = 0.030). PaCO 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, = 0.032]. 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. ClinicalTrials.Gov: NCT02439333.
ISSN:1178-2005
1176-9106
1178-2005
DOI:10.2147/COPD.S283020