Transnasal High-Flow Oxygen Therapy versus Noninvasive Positive Pressure Ventilation in the Treatment of COPD with Type II Respiratory Failure: A Meta-Analysis

Abstract

Objective. To compare the safety and efficacy of transnasal high-flow oxygen therapy (HFNT) and noninvasive positive pressure ventilation (NIV) in the treatment of chronic obstructive pulmonary disease (COPD) with type II respiratory failure. Methods. PubMed, the Cochrane Library, Embase, CBM, CNKI, and other databases were searched for randomized controlled trials (RCTS) on the efficacy of HFNT and NIV in the treatment of COPD. Meta-analysis was conducted using RevMan 5.3 software after two researchers screened literatures, extracted data, and evaluated the methodological quality of the included studies according to inclusion and exclusion criteria. Results. A total of 948 patients were included in 12 RCTS. Comprehensive analysis results showed that the HFNC group had higher levels of 12 h-PAO2, 48 h-PACO2 and, 48 h-pH than the NIV group, and the differences were statistically significant ( P < 0.05 ). There were no significant differences in 24 h-PAO2 and 72 h-PAO2, 12 h-PACO2, 24 h-PACO2 and 72 h-PACO2, 24 h-pH, 48 h-pH, and 72 h-pH between the two groups after treatment ( P > 0.05 ). Conclusions. Compared with NIV, HFNC does not increase the treatment failure rate in COPD patients with type II respiratory failure, and HFNC has better comfort and tolerance, which is a new potential respiratory support treatment for COPD patients with type II respiratory failure.

Analysis of therapeutic effects on type II respiratory failure and impact on blood gas changes: high-flow nasal oxygen therapy vs. non-invasive positive pressure ventilation

“…Diagnostic criteria for type II respiratory failure include an arterial oxygen partial pressure (PaO 2 ) below 60 mmHg and an arterial carbon dioxide partial pressure (PaCO 2 ) exceeding 50 mmHg. This disease is characterized by a rapid onset, swift progression, and a notably high mortality rate, significantly impacting patient survival [3,4]. Consequently, prompt and efficacious interventions are imperative in the management of type II acute respiratory failure, with the goal of alleviating clinical symptoms and reducing mortality.…”

Effects of high-flow nasal cannula oxygen therapy for patients with acute exacerbation of chronic obstructive pulmonary disease in combination with type II respiratory failure

“…It is characterized by airflow limitation with persistent and progressive dyspnea and is often accompanied by chronic coughing and chest tightness. [1][2] Acute exacerbations of COPD (AECOPD) are more common in middle-aged and older patients, often occur in combination with type II respiratory failure, and are characterized by weak coughing, concomitant infection, and poor lung function, which have negative effects on patient health, and increase the risks of hospitalization, readmission and disease progression. As AECOPD worsens, CO 2 retention and hypercapnic respiratory failure may occur.…”

Effect of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler combined with nasal high-flow nasal cannula on elderly patients with COPD and respiratory failure

“… 5 This treatment heats and humidifies inhaled gases, allowing patients to freely eat and breathe, which is more in line with their physiological needs, and can provide high concentration medication and oxygen concentration accuracy, which is conducive to improving ventilation function. 5 , 6 Budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler (BGF MDI) is a new therapeutic drug for respiratory diseases, which combines the advantages of formoterol, glucuronium bromide, and budesonide, and can synergistically improve COPD. 7 Based on the therapeutic effects of HFNC and BGF MDI, we supposed that the combination of the two may further improve their clinical effects.…”