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High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure.
Clin Respir J. 2018 Jun; 12(6):2046-2056.CR

Abstract

INTRODUCTION

Severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a significant event that results in substantial mortality.

OBJECTIVES

We evaluated the effectiveness of the high flow nasal cannulae (HFNC) therapy in severe AECOPD with moderate hypercapnic acute respiratory failure (ARF) compared to non-invasive ventilation (NIV).

METHODS

The prospective observational trial was performed to compare the effectiveness between the HFNC and NIV in severe AECOPD with moderate hypercapnic ARF. The end point was the intubation rate and 30-day mortality.

RESULTS

Ninety-two AECOPD patients enrolled during study periods. The median age was 73 (66.5-79) years, and 57 patients (64.8%) were male. Forty-four patients were assigned to HFNC, and 44 patients were assigned to NIV. The intubation rate at day 30 was 25.0% in the HFNC group and 27.3% in the NIV group (P = .857), and the 30-day mortality was 15.9% in the HFNC group and 18.2% in the NIV group (P = .845). The pH (7.38 ± 0.59 vs 7.36 ± 0.10, P = .295), PaO2 (82.2 ± 24.9 vs 81.6 ± 21.7 mm Hg, P = .899) and PaCO2 (46.8 ± 15.2 vs 51.7 ± 17.2 mm Hg, P = .160) after 6 hours and the pH (7.39 ± 0.07 vs 7.39 ± 0.08, P = .743), PaO2 (84.3 ± 18.5 vs 84.7 ± 23.2 mm Hg, P = .934) and PaCO2 (47.0 ± 16.0 vs 49.6 ± 13.7 mm Hg, P = .422) after 24 hours were not significantly different.

CONCLUSION

There was no difference of the 30-day mortality and intubation rate between HFNC and NIV groups.

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    Authors+Show Affiliations

    Lee MK
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Choi J
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Park B
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Kim B
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Lee SJ
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Kim SH
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Yong SJ
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Choi EH
    Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.
    Lee WY
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, South Korea.

    MeSH

    AgedAged, 80 and overCannulaFemaleHumansHypercapniaIntensive Care UnitsMaleNasal CavityNoninvasive VentilationOxygenOxygen Inhalation TherapyPrognosisProspective StudiesRepublic of KoreaRespiratory InsufficiencySurvival Rate

    Pub Type(s)

    Journal Article
    Observational Study

    Language

    eng

    PubMed ID

    29392846

    Citation

    Lee, Myoung Kyu, et al. "High Flow Nasal Cannulae Oxygen Therapy in Acute-moderate Hypercapnic Respiratory Failure." The Clinical Respiratory Journal, vol. 12, no. 6, 2018, pp. 2046-2056.
    Lee MK, Choi J, Park B, et al. High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure. Clin Respir J. 2018;12(6):2046-2056.
    Lee, M. K., Choi, J., Park, B., Kim, B., Lee, S. J., Kim, S. H., Yong, S. J., Choi, E. H., & Lee, W. Y. (2018). High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure. The Clinical Respiratory Journal, 12(6), 2046-2056. https://doi.org/10.1111/crj.12772
    Lee MK, et al. High Flow Nasal Cannulae Oxygen Therapy in Acute-moderate Hypercapnic Respiratory Failure. Clin Respir J. 2018;12(6):2046-2056. PubMed PMID: 29392846.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure. AU - Lee,Myoung Kyu, AU - Choi,Jaehwa, AU - Park,Bonil, AU - Kim,Bumjoon, AU - Lee,Seok Jeong, AU - Kim,Sang-Ha, AU - Yong,Suk Joong, AU - Choi,Eun Hee, AU - Lee,Won-Yeon, Y1 - 2018/03/05/ PY - 2016/11/20/received PY - 2017/08/28/revised PY - 2018/01/26/accepted PY - 2018/2/3/pubmed PY - 2018/11/27/medline PY - 2018/2/3/entrez KW - chronic obstructive pulmonary disease KW - exacerbation KW - intubation KW - mortality KW - pneumonia KW - respiratory failure SP - 2046 EP - 2056 JF - The clinical respiratory journal JO - Clin Respir J VL - 12 IS - 6 N2 - INTRODUCTION: Severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a significant event that results in substantial mortality. OBJECTIVES: We evaluated the effectiveness of the high flow nasal cannulae (HFNC) therapy in severe AECOPD with moderate hypercapnic acute respiratory failure (ARF) compared to non-invasive ventilation (NIV). METHODS: The prospective observational trial was performed to compare the effectiveness between the HFNC and NIV in severe AECOPD with moderate hypercapnic ARF. The end point was the intubation rate and 30-day mortality. RESULTS: Ninety-two AECOPD patients enrolled during study periods. The median age was 73 (66.5-79) years, and 57 patients (64.8%) were male. Forty-four patients were assigned to HFNC, and 44 patients were assigned to NIV. The intubation rate at day 30 was 25.0% in the HFNC group and 27.3% in the NIV group (P = .857), and the 30-day mortality was 15.9% in the HFNC group and 18.2% in the NIV group (P = .845). The pH (7.38 ± 0.59 vs 7.36 ± 0.10, P = .295), PaO2 (82.2 ± 24.9 vs 81.6 ± 21.7 mm Hg, P = .899) and PaCO2 (46.8 ± 15.2 vs 51.7 ± 17.2 mm Hg, P = .160) after 6 hours and the pH (7.39 ± 0.07 vs 7.39 ± 0.08, P = .743), PaO2 (84.3 ± 18.5 vs 84.7 ± 23.2 mm Hg, P = .934) and PaCO2 (47.0 ± 16.0 vs 49.6 ± 13.7 mm Hg, P = .422) after 24 hours were not significantly different. CONCLUSION: There was no difference of the 30-day mortality and intubation rate between HFNC and NIV groups. SN - 1752-699X UR - https://www.unboundmedicine.com/medline/citation/29392846/full_citation L2 - https://doi.org/10.1111/crj.12772 DB - PRIME DP - Unbound Medicine ER -
    Grapherence [↓13]

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