Acute exacerbation of chronic obstructive pulmonary disease,Respiratory failure
Conditions
Interventions
Control group:Non-invasive mechanical ventilation
Experimental group:Nasal high-flow humidification oxygen therapy
Sponsors
Qilu Hospital of Shandong University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. All patients meet the diagnostic criteria for chronic obstructive pulmonary disease in GOLD 2021: (1) Symptoms: respiratory symptoms such as long-term chronic cough, expectoration, shortness of breath or dyspnea, and systemic symptoms such as weight loss, loss of appetite, cyanosis, mental depression or anxiety; (2) Risk factors: long-term heavy smoking, exposure to harmful gases and particles such as occupational dust, smog, indoor biofuels, low socioeconomic status, human immunodeficiency virus (HIV) infection, etc. 2. Severe dyspnea and poor response to initial treatment; 3. Changes in the state of consciousness (such as confusion, lethargy, coma, etc.); 4. The results of blood gas analysis meet the diagnostic criteria for type II respiratory failure: that is, at sea level atmospheric pressure, breathing room air under resting conditions, and excluding intracardiac anatomical shunt and primary cardiac output reduction, arterial blood The partial pressure of oxygen (PaO2) is lower than 8kPa (60mmHg), and the partial pressure of carbon dioxide in the arterial blood is higher than 6.65kPa (50mmHg).
Exclusion criteria
Exclusion criteria: 1. Those who need to establish an artificial airway but refuse to accept it and eventually lead to death 2. Severe hypercapnia (PaCO2>75mm Hg) at the time of admission; 3. Patients who underwent tracheal intubation or tracheotomy within 24 hours after admission; 4. Patients with disturbance of consciousness or combined mental illness; 5. Patients with severe cardiac insufficiency, liver and kidney insufficiency; 6. Patients with asthma, pulmonary tuberculosis, interstitial lung disease, thoracic deformity, malignant tumor, myasthenia gravis; 7. Patients with recent surgery, trauma, or severe infection; 8. Interruption of assisted ventilation therapy; 9. Do not cooperate with blood sampling to monitor experimental indicators.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Respiratory rate;Heart rate;Blood pressure;Blood gas analysis;Oxygenation index;Mean ventilation;Average tidal volume;Glasgow Coma Score;Acute Physiology and Chronic Health Status Score II ;Clinical lung infection score ; | — |
Countries
China
Contacts
Public ContactQu Yiqing
Qilu Hospital of Shandong University
Outcome results
None listed