Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2023; 11(32): 7770-7777
Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7770
Clinical study of NFNC in the treatment of acute exacerbation chronic obstructive pulmonary disease patients with respiratory failure
Xiang Chen, Ling Dai, Jin-Zhu Ma, Xin-Xu Chu, Liang Dai, Jian-Ming Liu, Si-Wei Guo, Xin-Wei Ru, Xue-Shi Zhuang
Xiang Chen, Pulmonary and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan 430000, Hubei Province, China
Ling Dai, Department of Intensive Care Second Unit, Wuhan No. 1 Hospital, Wuhan 430000, Hubei Province, China
Jin-Zhu Ma, Xin-Xu Chu, Liang Dai, Jian-Ming Liu, Si-Wei Guo, Xin-Wei Ru, Xue-Shi Zhuang, Department of Intensive Care Medicine, Lixin County People's Hospital, Bozhou 236700, Anhui Province, China
Co-first authors: Xiang Chen and Ling Dai.
Author contributions: Chen X, Dai L, Ma JZ, and Chu XX designed the research; Dai L, Liu JM, and Guo SW performed the research; Ru XW and Zhuang XS contributed new reagents/analytic tools; Zhuang XS analyzed the data; Chen X and Dai L wrote the paper; Chen X and Dai L contributed equally to this work as co-first authors equally to this work. The reasons for designating Chen X and Dai L as co-first authors are three-fold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability; Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-first authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives; Third, Chen X and Dai L contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Chen X and Dai L as co-first authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Institutional review board statement: This study protocol was approved by the The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, and all families have voluntarily participated in the study and have signed informed consent forms.
Informed consent statement: Informed written consent was obtained from the patient for publication of this study.
Conflict-of-interest statement: All the authors declared no conflict of interest existing in this paper.
Data sharing statement: Data generated from this investigation are available upon reasonable quest from the first author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Shi Zhuang, MM, Chief Physician, Department of Intensive Care Medicine, Lixin County People's Hospital, No. 17 Xiangyang Road, Lixin County, Bozhou 236700, Anhui Province, China. xshizhuang@163.com
Received: September 21, 2023
Peer-review started: September 21, 2023
First decision: September 28, 2023
Revised: October 9, 2023
Accepted: October 30, 2023
Article in press: October 30, 2023
Published online: November 16, 2023
Processing time: 55 Days and 18 Hours
Abstract
BACKGROUND

Most patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment. High flow nasal cannula (HFNC) oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state, reduces dead space ventilation and breathing effort, protects the loss of cilia in the airways, and improves patient comfort.

AIM

To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.

METHODS

Eighty AECOPD patients were included in the study. The patients were in the intensive care department of our hospital from October 2019 to October 2021. The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group. Differences in patient comfort, blood gas analysis and infection indices were analyzed between the two groups.

RESULTS

After treatment, symptoms including nasal, throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3rd and 5th days (P < 0.05). Before treatment, the PaO2, PaO2/FiO2, PaCO2, and SaO2 in the two groups of patients were not significantly different (P > 0.05). After treatment, the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group (P < 0.05). After treatment, the white blood cell count, and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group (P < 0.05).

CONCLUSION

HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort, and reducing complications. HFNC is a clinically valuable technique for the treatment of AECOPD.

Keywords: Acute exacerbation chronic obstructive pulmonary disease; HFNC; Noninvasive positive pressure ventilation; Application value

Core Tip: Patients with acute exacerbation of obstructive pulmonary disease have respiratory failure, so improving oxygenation is the most important thing. The purpose of this study is to compare the efficacy of HFNC and noninvasive positive pressure ventilation in treating acute exacerbation chronic obstructive pulmonary disease (AECOPD) patients. By analyzing and comparing the differences of patients' comfort, blood gas analysis and infection index under different treatment methods. The results show that HFNC treatment can improve the ventilation function of patients with AECOPD, improve their comfort and reduce complications. This study shows that HFNC is a clinically valuable technique for the treatment of AECOPD.