Therapeutic effects of transnasal low-flow oxygen therapy after noninvasive mechanical ventilation on acute exacerbation of chronic obstructive pulmonary disease complicated by type II respiratory failure / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of transnasal low-flow oxygen therapy after noninvasive mechanical ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by type II respiratory failure.Methods:This study is a retrospective study. A total of 200 patients with AECOPD complicated by type II respiratory failure who received treatment in The First People's Hospital of Huzhou from January 2021 to March 2023 were selected as the research subjects through the health management platform of The First People's Hospital of Huzhou. These patients were divided into a control group and an observation group ( n = 100 per group) according to the treatment methods. The control group received noninvasive mechanical ventilation but without transnasal low-flow oxygen therapy. The observation group received noninvasive mechanical ventilation and transnasal low-flow oxygen therapy. The anti-inflammatory factors (interleukin 10 and transforming growth factor-beta) and pro-inflammatory factors (tumor necrosis factor-alpha and interleukin 6) were measured by enzyme-linked immunosorbent assay in both groups. Oxygen pressure and carbon dioxide pressure were compared between the two groups before and after treatment. The relief and disappearance time of symptoms such as fever, difficulty in breathing, palpitations, and difficulty in coughing were compared between the two groups. Statistical analysis was performed using IBM SPSS 26.0 software. Results:After treatment, the interleukin-10 level in the control group was (21.45 ± 7.02) ng/L, which was significantly lower than (26.77 ± 9.40) ng/L in the observation group ( t = 4.54, P < 0.001). The interleukin-6 level in the control group was (25.56 ± 8.58) ng/L, which was significantly higher than (18.98 ± 5.78) ng/L in the observation group ( t = 6.37, P < 0.001). Oxygen pressure in the control group was (71.41 ± 5.91) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than (93.69 ± 4.45) mmHg in the observation group ( t = 30.09, P = 0.004). Carbon dioxide pressure in the control group was (43.85 ± 2.99) mmHg, which was significantly higher than (37.87 ± 4.48) mmHg in the observation group ( t = 11.10, P < 0.001). The time to fever relief in the control group was (6.59 ± 1.51) days, which was significantly longer than (6.13 ± 1.19) days in the observation group ( t = 2.39, P = 0.008). The time to dyspnea relief in the control group was (5.61 ± 2.17) days, which was significantly longer than (4.47 ± 1.73) days in the observation group ( t = 4.10, P = 0.021). Conclusion:Noninvasive mechanical ventilation combined with transnasal low-flow oxygen therapy exhibits good therapeutic effects on inflammation control, symptom relief, and pulmonary function recovery in patients with AECOPD combined with type II respiratory failure.