Comparing the Outcome of Using High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation for Chronic Obstructive Pulmonary Disease Patients with Acute Hypercapnic Respiratory Failure

Abstract

Abstract Background Noninvasive ventilation (NIV) is frequently employed as a treatment option for acute hypercapnic respiratory failure (AHRF) resulting from chronic obstructive pulmonary disease (COPD). Limited research has substantiated the claims made in recent studies regarding the feasibility of employing high flow nasal cannula (HFNC). Aim Our study assessed the outcome of using HFNC versus NIV for COPD patients with AHRF. Patients and Methods Eighty COPD patients with AHRF were confined to the respiratory intensive care unit (RICU) at Ain Shams university hospitals from December 2021 to 2023 and subdivided into 2 groups (40/group), where the first group was placed on NIV, while the second group was placed on HFNC. Data during their hospital stay as demographic data, vital data, arterial blood gases, device duration, treatment failure and mortality were recorded. Results The majority were males with mean age 63.75 ± 9.05 years along with treatment failure and complications 25%,27.5% in NIV versus 45%,10% in HFNC respectively, with longer hospital stay in NIV (10-15 days) to (7-10 days) in HFNC with no difference in mortality rate in both groups. Conclusion NIV and HFNC were both modalities for treating COPD with AHRF with no confirmed superiority of any of them; as treatment failure was apparently lower in NIV than HFNC along with apparently faster improvement in ventilatory and respiratory status but significantly NIV group was superior in length of hospitalization and incidence of complications than HFNC with no difference in mortality in both groups.