Acta clinica Croatica, Vol. 64. No. 2, 2025.
Original scientific paper
https://doi.org/10.20471/acc.2025.64.02.05
The Effectiveness of High Flow Oxygen Therapy and Noninvasive Mechanical Ventilation Treatment in Acute Respiratory Failure due to Chronic Obstructive Pulmonary Disease – a Randomized Study
Dilek Atik
orcid.org/0000-0002-3270-8711
; Department of Emergency Medicine, Yozgat Bozok University, Yozgat, Turkey
*
Basar Cander
; Department of Emergency Medicine, University of Health Sciences Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
Ramiz Yazici
; Department of Emergency Medicine, University of Health Sciences Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
Bensu Bulut
; Department of Emergency Medicine, University of Health Sciences Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
Ramazan Unal
; Department of Emergency Medicine, University of Health Sciences Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
Ramazan Guven
; Department of Emergency Medicine, University of Health Sciences Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
* Corresponding author.
Abstract
Hypercapnic acute respiratory failure (ARF) is a common complication of chronic
obstructive pulmonary disease (COPD). Respiratory support is required in ARF, which usually has a
high mortality risk. The objective was to compare the effectiveness of noninvasive mechanical ventilation
(NIV), which is the traditional treatment protocol for COPD, with high-flow nasal cannula oxygen
therapy (HFNT) as an emerging treatment method. This study was performed between August 20,
2019 and December 20, 2019, as a prospective randomized controlled study. Patients who were admitted
with ARF due to COPD were included in the study. With randomization, 30 patients were treated with
HFNT, whereas 31 patients were treated with NIV. The pH value of the HFNT group was significantly
higher at the 1st hour of treatment (p=0.001). While there were no significant differences in subsequent
pH values in the HFNT group (p=0.130), the pH value in the NIV group was found to have changed
significantly (p=0.030). Compared to the NIV group, the 1st hour PaCO2 value in the HFNT group
was significantly higher (p<0.001). The PaCO2 value decreased and PaO2 value increased significantly
during follow-up in both groups (p<0.001). There were no significant differences in intra-group lactate
and HCO3 values in the HFNT group, whereas the corresponding changes in the NIV group were
significant (p=0.002). Compared to the HFNT group, the NIV group length of stay in the intensive
care unit (ICU) was significantly longer (p=0.039). The use of HFNT, especially in more serious COPD
patients, can be described as an intervention that could be beneficial in the acute period and could reduce
the frequency of nosocomial infections by shortening ICU stay.
Keywords
Chronic obstructive pulmonary disease; Acute respiratory failure; Noninvasive mechanical ventilation; High-flow nasal cannula oxygen therapy
Hrčak ID:
337538
URI
Publication date:
30.6.2025.
Visits: 138 *