Aim: we conducted this study to evaluate the effect of high-velocity nasal cannula (HVNC) compared with noninvasive positive pressure ventilation (NIPPV) in reducing the need for endotracheal intubation in patients with respiratory failure due to COPD exacerbation and the outcome in both methods. Patients and methods: Our study is a randomized controlled trial that was conducted on patients admitted to the ICU by COPD exacerbation in the critical care department and chest department in Beni-Suef University, from February 2022 to January 2023, with a sample size of 40 patients divided into two groups, group (A) consists of 20 patients subjected to NIPPV, and group (B) consists of 20 patients subjected to HVNC. Results: SO2 significantly increased from 1st hour (80.8±7.9%) to 2nd hour (93.9±1.5%). PH increased significantly in both groups, with no significant difference between the two groups after 2 hours. PCO2 decreased significantly in both groups, with more improvement in HVNC. PO2 and HCO3 didn't differ significantly after 2 hours, and there were no significant differences between the two groups. There were insignificant differences between the studied groups regarding the need for intubation, mortality, length of stay, and SAPS score, but the Borg scale was higher in the NIPPV group than the HVNC group. Conclusion: in conclusion, both HVNC and NIPPV are effective in COPD exacerbation in decreasing the carbon dioxide with more improvement in the HVNC group. There was a significant role of HVNC in decreasing intolerance and respiratory distress and the Borg dyspnea scale.
Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017;50(2):1602426.
Spoletini G, Cortegiani A, Gregoretti C. Physiopathological rationale of using high-flow nasal therapy in the acute and chronic setting: a narrative review. TACC. 2019;1;26:22-9.
Groves N, Tobin A. High flow nasal oxygen generates positive airway pressure in adult volunteers. Aust Crit Care. 2007;20(4):126-131.
Ricard JD, Roca O, Lemiale V, et al. Use of nasal high flow oxygen during acute respiratory failure. Intensive Care Med. 2020;46(12):2238-2247.
Fontanari P, Zattara-Hartmann MC, Burnet H, Jammes Y. Nasal eupnoeic inhalation of cold, dry air increases airway resistance in asthmatic patients. Eur Respir J. 1997;10(10):2250-2254.
On LS, Boonyongsunchai P, Webb S, Davies L, Calverley PM, Costello RW. Function of pulmonary neuronal M(2) muscarinic receptors in stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;163(6):1320-1325.
Kilgour E, Rankin N, Ryan S, Pack R. Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity. Intensive Care Med. 2004;30(7):1491-1494.
Crimi C, Noto A, Cortegiani A, et al. High Flow Nasal Therapy Use in Patients with Acute Exacerbation of COPD and Bronchiectasis: A Feasibility Study. COPD. 2020;17(2):184-190.
Pisani L, Fasano L, Corcione N, et al. Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnic COPD. Thorax. 2017;72(4):373-375.
Jing G, Li J, Hao D, et al. Comparison of high Flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial. Res Nurs Health. 2019;42(3):217-225.
Luo Z, Cao Z, Li Y, et al. Physiological effects of high-intensity versus low-intensity noninvasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease: a randomised controlled trial. Ann Intensive Care. 2022;12(1):41.
Fahey AC, O'Connell M, Cornally N, Saab MM. High Flow nasal cannula versus noninvasive ventilation in the treatment of acute hypercapnic respiratory failure: A systematic review and meta-analysis. Clin Respir J. 2023;17(11):1091-1102.
Mittal A, Varshney M, Rathi V, Ish P. High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility. Monaldi Arch Chest Dis. 2020;90(1):10.4081/monaldi.2020.1158.
Plotnikow GA, Accoce M, Fredes S, et al. High-Flow Oxygen Therapy Application in Chronic Obstructive Pulmonary Disease Patients With Acute Hypercapnic Respiratory Failure: A Multicenter Study [published correction appears in Crit Care Explor. 2021 Mar 19;3(3):e0376]. Crit Care Explor. 2021;3(2):e0337.
Plant PK, Owen JL, Elliott MW. Noninvasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: long term survival and predictors of in-hospital outcome. Thorax. 2001;56(9):708-712.
Dreher M, Storre JH, Schmoor C, Windisch W. High-intensity versus low-intensity noninvasive ventilation in patients with stable hypercapnic COPD: a randomised crossover trial. Thorax. 2010;65(4):303-308.
Lukácsovits J, Carlucci A, Hill N, et al. Physiological changes during low- and high-intensity noninvasive ventilation. Eur Respir J. 2012;39(4):869-875.
Cao Z, Luo Z, Hou A, et al. Volume-Targeted Versus Pressure-Limited Noninvasive Ventilation in Subjects With Acute Hypercapnic Respiratory Failure: A Multicenter Randomized Controlled Trial. Respir Care. 2016;61(11):1440-1450. doi:10.4187/respcare.04619
Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017;50(2):1602426.
Ovtcharenko N, Ho E, Alhazzani W, et al. High-flow nasal cannula versus noninvasive ventilation for acute hypercapnic respiratory failure in adults: a systematic review and meta-analysis of randomized trials. Crit Care. 2022;26(1):348.
Xu Z, Zhu L, Zhan J, Liu L. The efficacy and safety of high-flow nasal cannula therapy in patients with COPD and type II respiratory failure: a meta-analysis and systematic review. Eur J Med Res. 2021;26(1):122. doi:10.1186/s40001-021-00587-7
Yang PL, Yu JQ, Chen HB. High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis. Heart Lung. 2021;50(2):252-261.
Hancı P, Öcal S, Kaya EK, Topeli A. The Use of High-Flow Nasal Oxygen Therapy in the Management of Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Feasibility Study. Turk Thorac J. 2022;23(5):336-342.
Tan D, Walline JH, Ling B, et al. High-flow nasal cannula oxygen therapy versus noninvasive ventilation for chronic obstructive pulmonary disease patients after extubation: a multicenter, randomized controlled trial. Crit Care. 2020;24(1):489.
Cortegiani A, Longhini F, Madotto F, et al. High flow nasal therapy versus noninvasive ventilation as initial ventilatory strategy in COPD exacerbation: a multicenter non-inferiority randomized trial. Crit Care. 2020;24(1):692.
Agmy G, Adam M, Hsanen EH, Mahmoud MA. High-flow nasal cannula versus noninvasive ventilation in the prevention of escalation to invasive mechanical ventilation in patients with acute hypoxemic respiratory failure. Egypt J Chest Dis Tuberc. 2022;71(1), 81-81.
Doshi PB, Whittle JS, Dungan G 2nd, et al. The ventilatory effect of high velocity nasal insufflation compared to noninvasive positive-pressure ventilation in the treatment of hypercapneic respiratory failure: A subgroup analysis. Heart Lung. 2020;49(5):610-615.
Rezaei A, Fakharian A, Ghorbani F, Idani E, Abedini A, Jamaati H. Comparison of high-flow oxygenation with noninvasive ventilation in COPD exacerbation: A crossover clinical trial. Clin Respir J. 2021;15(4):420-429.
Sklar MC, Dres M, Rittayamai N, et al. High-flow nasal oxygen versus noninvasive ventilation in adult patients with cystic fibrosis: a randomized crossover physiological study. Ann Intensive Care. 2018;8(1):85.
Koga Y, Kaneda K, Fujii N, et al. Comparison of high-flow nasal cannula oxygen therapy and noninvasive ventilation as first-line therapy in respiratory failure: a multicenter retrospective study. Acute Med Surg. 2019;7(1):e461.
ELkholy, M., Yousef, E., Saber, H., & Abo Hamila, M. (2024). Effect of High velocity Nasal Cannula compared with Noninvasive Positive Pressure Ventilation in Patients with COPD Exacerbation. The Egyptian Journal of Intensive Care and Emergency Medicine, 4(1), 66-79. doi: 10.21608/jicem.2024.275787.1031
MLA
Mohamed Bakry ELkholy; Esraa Hassan Yousef; Hamdy Mohammed Saber; Mohammed Abd Elkader Abo Hamila. "Effect of High velocity Nasal Cannula compared with Noninvasive Positive Pressure Ventilation in Patients with COPD Exacerbation", The Egyptian Journal of Intensive Care and Emergency Medicine, 4, 1, 2024, 66-79. doi: 10.21608/jicem.2024.275787.1031
HARVARD
ELkholy, M., Yousef, E., Saber, H., Abo Hamila, M. (2024). 'Effect of High velocity Nasal Cannula compared with Noninvasive Positive Pressure Ventilation in Patients with COPD Exacerbation', The Egyptian Journal of Intensive Care and Emergency Medicine, 4(1), pp. 66-79. doi: 10.21608/jicem.2024.275787.1031
VANCOUVER
ELkholy, M., Yousef, E., Saber, H., Abo Hamila, M. Effect of High velocity Nasal Cannula compared with Noninvasive Positive Pressure Ventilation in Patients with COPD Exacerbation. The Egyptian Journal of Intensive Care and Emergency Medicine, 2024; 4(1): 66-79. doi: 10.21608/jicem.2024.275787.1031