Abstract
Background: Chronic obstructive pulmonary disease is a
common and treatable disease. It is characterized by
progressive airflow narrowing. Traditional oxygen therapy
often inadequately addresses severe hypoxia or hypercapnia in
COPD patients. Non-invasive ventilation became the standard
treatment. However, NIV masks can cause discomfort and
intolerance, leading to treatment failure. High-flow nasal
cannula (HFNC) offers a promising alternative by delivering
heated, humidified oxygen with precise control, improving
ventilation, oxygenation, and patient comfort. This study
aims to compare the efficacy of HNFC versus NIV in
managing patients with hypercapnic acute exacerbation of
chronic obstructive pulmonary disease. Methods: This
prospective randomized controlled trial was conducted at
respiratory intensive care unit at Benha University Hospital
between January 2023 to January 2024.Forty patients were
randomized into observational group A (use HFNC, n=20) and
control group B (use NIV low- flow o2, n=20). Results: There
was no significant difference between both studied groups
regarding outcome after therapy; 70% of cases treated with
HFNC versus 80% of cases exposed to NIV improved, and
there were no differences in respiratory support duration,
length of ICU and hospital stay between both groups.
However, a significantly higher number of patients reported comfort with HFNC
compared to NIV and the prevalence of noisiness was significantly higher in the NIV
group. Conclusion: HFNC was non-inferior to NIV regarding ABG parameters during or
after therapy, duration of support, ICU or hospital stay and outcome (including treatment
failure and mortality). However, HFNC was better than NIV regarding patient comfort
during therapy.