Evaluation of the effectiveness and factors associated with the treatment outcomes of high‑flow nasal cannula and bilevel positive airway pressure in patients with chronic obstructive pulmonary disease with moderate respiratory failure

The present study compared the effectiveness of the non‑invasive respiratory support therapies, bilevel positive airway pressure (BiPAP) and high‑flow nasal cannula (HFNC) in 176 patients with chronic obstructive pulmonary disease (COPD) with hypercapnia, divided into two treatment groups. The results indicated that the BiPAP group achieved a significant reduction in the mean partial pressure of carbon dioxide in arterial blood, decreasing from 54.14±10.40 to 47.06±5.99 mmHg, compared with a reduction from 55.97±10.50 to 50.31±7.32 mmHg in the HFNC group. Oxygen saturation levels were more stable in the BiPAP group, particularly prior to the intervention and at 2 h. Additionally, BiPAP significantly reduced breathing effort, with respiratory rates decreasing from 27.02±1.36 to 22.09±10.23 breaths/min, compared with a reduction from 26.07±1.99 to 22.36±1.83 breaths/min in the HFNC group. HFNC was associated with greater patient comfort, with 85% of the patients reporting ease of use, compared with 68% in the BiPAP group. In conclusion, BiPAP remains the preferred treatment for acute COPD exacerbations with hypercapnia, while HFNC serves as an adjunct option for milder cases or long‑term support.