Journal of Advances in Clinical Nursing

Objective To investigate the clinical efficacy of high-flow nasal cannula oxygen therapy (HFNC) in the treatment of patients with acute exacerbation of bronchiectasis and type II respiratory failure. Methods A total of 40 patients with acute exacerbation of bronchiectasis and type II respiratory failure admitted to the Department of Respiratory and Critical Care Medicine of our hospital from July 2020 to January 2023 were selected as the study objects. The patients were divided into traditional oxygen therapy group (20 cases) and HFNC group (20 cases) by random number table method. All patients were given anti-infection, expectorant and other conventional treatment, the traditional oxygen therapy group was given nasal catheter oxygen, HFNC group was given HFNC treatment. Blood gas analysis indexes (arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and oxygenation index (PaO2/FiO2)), respiratory rate, heart rate, sputum viscosity and tolerance scores were compared between the two groups before treatment, 2h after treatment, 24h after treatment and before discharge. The incidence of adverse events and length of hospital stay were compared between the two groups. Results 2h, 24 h after treatment and before discharge, PaO2 and PaO2/FiO2 in 2 groups were higher than before treatment, and PaO2 and PaO2/FiO2 in HFNC group were higher than those in traditional oxygen therapy group, with statistical significance (P < 0.05). At 24 h after treatment and before discharge, PaCO2 in traditional oxygen therapy group was lower than that before treatment, and the difference was statistically significant (P < 0.05). PaCO2 in the HFNC group was lower than that before treatment 2h, 24h after treatment and before discharge, and PaCO2 in the HFNC group was lower than that in the traditional oxygen therapy group, the difference was statistically significant (P < 0.05). 2h, 24 h after treatment and before discharge, the respiratory rate and heart rate of patients in 2 groups were lower than before treatment, and the improvement of respiratory rate and heart rate in HFNC group was better than that in traditional oxygen therapy group, the difference was statistically significant (P < 0.05). The phlegm viscosity of traditional oxygen therapy group before discharge was better than that before treatment, and the difference was statistically significant (P < 0.05). The sputum viscosity of HFNC group at 2h, 24h after treatment and before discharge was better than that before treatment, the difference was statistically significant (P < 0.05). The phlegm viscosity of HFNC 24 hours after treatment and before discharge was better than that of traditional oxygen therapy group, and the difference was statistically significant (P < 0.05). The tolerance scores of HFNC group were better than those of traditional oxygen therapy group 2h, 24h after treatment and before discharge, and the difference was statistically significant (P < 0.05). After treatment, the incidence of adverse events (nasopharyngeal dryness and epistaxis) in HFNC group was lower than that in traditional oxygen therapy group, and the difference was statistically significant (P < 0.05). The length of hospital stay in HFNC group was less than that in traditional oxygen therapy group, and the difference was statistically significant (P < 0.05). Conclusion Nasal high-flow humidification oxygen therapy in the treatment of patients with acute exacerbation of bronchiectasis and type II respiratory failure has definite clinical efficacy. Compared with traditional oxygen therapy, it can improve blood gas analysis oxygenation and ventilation indexes faster and better, improve sputum viscosity, facilitate sputum drainage, shorten hospital stay, and be better tolerated and comfortable.

Nasal high flow humidified oxygen therapy; Bronchiectasis; Respiratory failure; Blood gas analysis