Transnasal High-Flow Oxygen Therapy versus Noninvasive Positive Pressure Ventilation in the Treatment of COPD with Type II Respiratory Failure: A Meta-Analysis

OBJECTIVE: To compare the safety and efficacy of transnasal high-flow oxygen therapy (HFNT) and noninvasive positive pressure ventilation (NIV) in the treatment of chronic obstructive pulmonary disease (COPD) with type II respiratory failure. METHODS: PubMed, the Cochrane Library, Embase, CBM, CNKI, and other databases were searched for randomized controlled trials (RCTS) on the efficacy of HFNT and NIV in the treatment of COPD. Meta-analysis was conducted using RevMan 5.3 software after two researchers screened literatures, extracted data, and evaluated the methodological quality of the included studies according to inclusion and exclusion criteria. RESULTS: A total of 948 patients were included in 12 RCTS. Comprehensive analysis results showed that the HFNC group had higher levels of 12 h-PAO(2), 48 h-PACO(2) and, 48 h-pH than the NIV group, and the differences were statistically significant (P < 0.05). There were no significant differences in 24 h-PAO(2) and 72 h-PAO(2), 12 h-PACO(2), 24 h-PACO(2) and 72 h-PACO(2), 24 h-pH, 48 h-pH, and 72 h-pH between the two groups after treatment (P > 0.05). CONCLUSIONS: Compared with NIV, HFNC does not increase the treatment failure rate in COPD patients with type II respiratory failure, and HFNC has better comfort and tolerance, which is a new potential respiratory support treatment for COPD patients with type II respiratory failure.