Comparative study of noninvasive positive pressure ventilation and high-flow nasal cannula oxygen therapy in the treatment of patients with COPD and community-acquired pneumonia

This study aims to provide a reference for clinical treatment selection by comparing noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC) oxygen therapy in patients with chronic obstructive pulmonary disease (COPD) complicated by community-acquired pneumonia (CAP). From January 2022 to December 2023, 63 patients with COPD and CAP treated at our hospital were enrolled. Patients were allocated to either the NIV group (33 patients) or the HFNC group (30 patients), in addition to receiving conventional treatments. The groups were compared across various parameters including respiratory rate (RR), peripheral oxygen saturation (SpO2), arterial oxygen partial pressure (PaO2), oxygenation index (PaO2/fraction of inspiration O2 [FiO2]), rates of complications, tracheal intubation, mortality, total hospital stay, and hospital costs at 1, 3, and 7 days post-treatment. After 1, 3, and 7 days of treatment, both groups exhibited significant improvements in RR, SpO2, PaO2, and PaO2/FiO2 from baseline (P < .05). The improvements increased over time. However, no significant differences were observed between the NIV and HFNC groups in RR, SpO2, PaO2, and PaO2/FiO2 at the measured time points (P > .05); the HFNC group experienced lower rates of complications such as facial injuries, dry nose and mouth, and bloating (P < .05). No significant differences were found in tracheal intubation rates, mortality rates, total hospital stay, and total hospital costs between the groups (P > .05). Both NIV and HFNC effectively improve respiratory and circulatory parameters in patients with COPD and CAP, with similar efficacy rates. While there were no significant differences in tracheal intubation rates, mortality rates, total hospital duration, and costs, HFNC was associated with fewer complications and greater patient comfort, rendering it a more favorable clinical option.