Efficacy of High Flow Nasal Cannula Versus Noninvasive Ventilation in Acute Exacerbation of COPD

Authors

  • Tehzeeb Ashraf Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur, Punjab, Pakistan.
  • Muhammad Rauf Ul Hassan Professor of Pulmonology, Bahawal Victoria Hospital, Bahawalpur, Punjab, Pakistan.
  • Muhammad Asif Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur, Punjab, Pakistan.
  • Niaz Liaqat Department of Pulmonology, Bahawal Victoria Hospital, Bahawalpur, Punjab, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i7.1422

Keywords:

COPD, Exacerbation, HFNC, NIV

Abstract

Introduction: COPD is a familiar treatable disorder, Despite the availability of various treatment options, there is limited local evidence to guide the most effective and accessible treatment strategies in resource-constrained settings, Non-Invasive Ventilation (NIV) has been widely used as the standard of care for managing AECOPD; however, recent advancements, such as High-Flow Nasal Cannula (HFNC), offer a promising alternative. Materials & Methods: There were 200 patients with acute exacerbations of COPD, both male and female, ranging in age from 20 to 70.  Individuals suffering from systemic illnesses such as chronic liver disease, heart failure, renal failure, hematological disorders, bronchiectasis, pneumonia, life-threatening hypoxemia, agitation, confusion, bowel obstruction, vomiting, upper gastrointestinal surgery, hemodynamic instability requiring pressors or inotropes, trauma, facial burns, or recent upper airway or facial surgery were not included.  Group A received non-invasive ventilation (NIV).  Group B received high flow nasal oxygen treatment.  The following parameters were used to determine the frequency of treatment success: pH >7.35, a decrease in PaCO2 of >15–20% with SaO2 (with or without oxygen) of >90%, and a decrease in respiratory rate of >20% compared with spontaneous breathing. All patients were monitored for 24 hours. Results: The study's age range was 20 to 70 years old, with a mean age of 57.79 ± 4.93 years. Patients in group A were 57.69 ± 5.01 years old on average, while those in the group B were 57.84 ± 4.91 years old. Out of 200 patients, 132 (66.0%) were males and 68 (34.0%) were females with male to female ratio of 1.9:1. At the end of 24 hours of treatment, 73 patients (73.0%) in group A (noninvasive ventilation) and 89 patients (89.0%) in group B (nasal high-flow oxygen) showed successful with 0.0039 significant p-value. Conclusion: This study demonstrated the efficacy of nasal high-flow oxygen is better than noninvasive ventilation in acute exacerbation of COPD.

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References

Du, Y., Zhang, H., Ma, Z., Liu, J., Wang, Z., Lin, M., Ni, F., Li, X., Tan, H., Tan, S., Chai, Y., & Zhong, X. (2023). High-flow nasal oxygen versus Noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease patients: A meta-analysis of randomized controlled trials. Canadian Respiratory Journal, 2023, 1-12.

https://doi.org/10.1155/2023/7707010

Magdy, D. M., & Metwally, A. (2023). Effect of high-flow nasal cannula versus non-invasive ventilation in preventing re-intubation in high-risk chronic obstructive pulmonary disease patients: A randomised controlled trial. Lung India, 40(4), 312-320.

https://doi.org/10.4103/lungindia.lungindia_338_22

Xu, C., Yang, F., Wang, Q., & Gao, W. (2023). Comparison of high flow nasal therapy with non-invasive ventilation and conventional oxygen therapy for acute Hypercapnic respiratory failure: A meta-analysis of randomized controlled trials. International Journal of Chronic Obstructive Pulmonary Disease, 18, 955-973.

https://doi.org/10.2147/copd.s410958

Veenstra, P., Veeger, N. J., Koppers, R. J., Duiverman, M. L., & Van Geffen, W. H. (2022). High-flow nasal cannula oxygen therapy for admitted COPD-patients. A retrospective cohort study. PLOS ONE, 17(10), e0272372.

https://doi.org/10.1371/journal.pone.0272372

Ovtcharenko, N., Ho, E., Alhazzani, W., Cortegiani, A., Ergan, B., Scala, R., Sotgiu, G., Chaudhuri, D., Oczkowski, S., & Lewis, K. (2022). High-flow nasal cannula versus non-invasive ventilation for acute hypercapnic respiratory failure in adults: A systematic review and meta-analysis of randomized trials. Critical Care, 26(1).

https://doi.org/10.1186/s13054-022-04218-3

Maia, I. S., Kawano-Dourado, L., Zampieri, F. G., Damiani, L. P., Nakagawa, R. H., Gurgel, R. M., Negrelli, K., Gomes, S. P., Paisani, D., Lima, L. M., Santucci, E. V., Valeis, N., Laranjeira, L. N., Lewis, R., Fitzgerald, M., Carvalho, C. R., Brochard, L., & Cavalcanti, A. B. (2022). High flow nasal catheter therapy versus non-invasive positive pressure ventilation in acute respiratory failure (Renovate trial): Protocol and statistical analysis plan. Critical Care and Resuscitation, 24(1), 61-70.

https://doi.org/10.51893/2022.1.oa8

Golmohamad, A., Johnston, R., Hay, K., & Tay, G. (2022). Safety and efficacy of high‐flow nasal cannula therapy in acute hypercapnic respiratory failure: A retrospective audit. Internal Medicine Journal, 52(2), 259-264.

https://doi.org/10.1111/imj.15400

Rezaei, A., Fakharian, A., Ghorbani, F., Idani, ‪., Abedini, A., & Jamaati, H. (2020). Comparison of high‐flow oxygenation with noninvasive ventilation in COPD exacerbation: A crossover clinical trial. The Clinical Respiratory Journal, 15(4), 420-429. ‬

https://doi.org/10.1111/crj.13315

Ischaki, E., Pantazopoulos, I., Manoulakas, E., Boutlas, S., Papalampidou, A., Moylan, M., Ferdoutsis, E., Meletis, G., Athanasiou, N., Boulia, S., Gourgoulianis, K., & Zakynthinos, S. (2019). Nasal high flow versus non-invasive ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. Noninvasive ventilatory support, PA2327.

https://doi.org/10.1183/13993003.congress-2019.pa2327

Thille, A. W., Coudroy, R., Nay, M., Gacouin, A., Decavèle, M., Sonneville, R., Beloncle, F., Girault, C., Dangers, L., Lautrette, A., Levrat, Q., Rouzé, A., Vivier, E., Lascarrou, J., Ricard, J., Razazi, K., Barberet, G., Lebert, C., & Frat, J. (2021). Non-invasive ventilation alternating with high-flow nasal oxygen versus high-flow nasal oxygen alone after extubation in COPD patients: A post hoc analysis of a randomized controlled trial. Annals of Intensive Care, 11(1).

https://doi.org/10.1186/s13613-021-00823-7

Lee, M. K., Choi, J., Park, B., Kim, B., Lee, S. J., Kim, S., Yong, S. J., Choi, E. H., & Lee, W. (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

Sun, J., Li, Y., Ling, B., Zhu, Q., Hu, Y., Tan, D., Geng, P., & Xu, J. (2019). High flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: An observational cohort study. International Journal of Chronic Obstructive Pulmonary Disease, 14, 1229-1237.

https://doi.org/10.2147/copd.s206567

McKinstry, S., Singer, J., Baarsma, J. P., Weatherall, M., Beasley, R., & Fingleton, J. (2019). Nasal high‐flow therapy compared with non‐invasive ventilation in COPD patients with chronic respiratory failure: A randomized controlled cross‐over trial. Respirology, 24(11), 1081-1087.

https://doi.org/10.1111/resp.13575

Varmaghani, M., Dehghani, M., Heidari, E., Sharifi, F., Saeedi Moghaddam, S., & Farzadfar, F. (2019). Global prevalence of chronic obstructive pulmonary disease: Systematic review and meta-analysis. Eastern Mediterranean Health Journal, 25(1), 47-57.

https://doi.org/10.26719/emhj.18.014

Salvi, S. S., & Barnes, P. J. (2009). Chronic obstructive pulmonary disease in non-smokers. The Lancet, 374(9691), 733-743.

https://doi.org/10.1016/s0140-6736(09)61303-9

Tan, W. C., Sin, D. D., Bourbeau, J., Hernandez, P., Chapman, K. R., Cowie, R., FitzGerald, J. M., Marciniuk, D. D., Maltais, F., Buist, A. S., Road, J., Hogg, J. C., Kirby, M., Coxson, H., Hague, C., Leipsic, J., O'Donnell, D. E., & Aaron, S. D. (2015). Characteristics of COPD in never-smokers and ever-smokers in the general population: Results from the CanCOLD study. Thorax, 70(9), 822-829.

https://doi.org/10.1136/thoraxjnl-2015-206938

Du, Y., Zhang, H., Ma, Z., Liu, J., Wang, Z., Lin, M., Ni, F., Li, X., Tan, H., Tan, S., Chai, Y., & Zhong, X. (2023). High-flow nasal oxygen versus Noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease patients: A meta-analysis of randomized controlled trials. Canadian Respiratory Journal, 2023, 1-12.

https://doi.org/10.1155/2023/7707010

Yang, P., Yu, J., & Chen, H. (2021). High-flow nasal cannula for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis. Heart & Lung, 50(2), 252-261.

https://doi.org/10.1016/j.hrtlng.2020.12.010

Fahey, A. C., O'Connell, M., Cornally, N., & Saab, M. M. (2023). High flow nasal cannula versus noninvasive ventilation in the treatment of acute hypercapnic respiratory failure: A systematic review and meta‐analysis. The Clinical Respiratory Journal, 17(11), 1091-1102.

https://doi.org/10.1111/crj.13695

Tan, D., Wang, B., Cao, P., Wang, Y., Sun, J., Geng, P., Walline, J. H., Wang, Y., & Wang, C. (2024). High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: A randomized controlled non-inferiority trial. Critical Care, 28(1).

https://doi.org/10.1186/s13054-024-05040-9

Doshi, P., Whittle, J. S., Bublewicz, M., Kearney, J., Ashe, T., Graham, R., Salazar, S., Ellis, T. W., Maynard, D., Dennis, R., Tillotson, A., Hill, M., Granado, M., Gordon, N., Dunlap, C., Spivey, S., & Miller, T. L. (2018). High-velocity nasal insufflation in the treatment of respiratory failure: A randomized clinical trial. Annals of Emergency Medicine, 72(1), 73-83.e5.

https://doi.org/10.1016/j.annemergmed.2017.12.006

Tan, D., Wang, B., Cao, P., Wang, Y., Sun, J., Geng, P., Walline, J. H., Wang, Y., & Wang, C. (2024). High flow nasal cannula oxygen therapy versus non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: A randomized controlled non-inferiority trial. Critical Care, 28(1).

https://doi.org/10.1186/s13054-024-05040-9

Huang, H., Sun, X., Shi, Z., Chen, G., Chen, L., Friedrich, J. O., & Zhou, J. (2017). Effect of high-flow nasal cannula oxygen therapy versus conventional oxygen therapy and Noninvasive ventilation on Reintubation rate in adult patients after Extubation: A systematic review and meta-analysis of randomized controlled trials. Journal of Intensive Care Medicine, 33(11), 609-623.

https://doi.org/10.1177/0885066617705118

Xu, C., Yang, F., Wang, Q., & Gao, W. (2023). Comparison of high flow nasal therapy with non-invasive ventilation and conventional oxygen therapy for acute Hypercapnic respiratory failure: A meta-analysis of randomized controlled trials. International Journal of Chronic Obstructive Pulmonary Disease, 18, 955-973.

https://doi.org/10.2147/copd.s410958

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Published

2025-07-13

How to Cite

Ashraf, T., Rauf Ul Hassan, M., Asif, M., & Liaqat, N. (2025). Efficacy of High Flow Nasal Cannula Versus Noninvasive Ventilation in Acute Exacerbation of COPD. Indus Journal of Bioscience Research, 3(7), 95–99. https://doi.org/10.70749/ijbr.v3i7.1422

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