P-65 Clinical Efficacy of High-Flow Nasal Cannula in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Background/Aims: High-flow nasal cannula (HFNC) oxygen therapy has been used in patients with hypoxic respiratory failure, but the clinical benefit in acute exacerbation patients of chronic obstructive pulmonary disease (COPD) remains unclear. The aim of this study was to evaluate the clinical efficacy of HFNC, especially at hypercapnic respiratory failure. Methods: A retrospective analysis was performed at a single medical center in South Korea. In total, 52 patients with acute exacerbation of COPD were enrolled: devided two groups, 37 patients with arterial carbon dioxide of ＜ 45 mmHg (non-hypercapnic group) and 15 patients with arterial carbon dioxide of ≥ 45 mmHg (hypercapnic group) from April 2011 to December 2015. Results: Mean of baseline arterial carbon dioxide level was 38.3 ± 11.76 in total patients, 32.4 ± 6.96 mmHg in non-hypercapnic group and 52.8 ± 7.80 mmHg in hypercapnic group. There was a significant decrease of arterial carbon dioxide level at the time of 12 hour (pCO2is 48.9 ± 8.6 mmHg and Δ pCO2is -4.3 mmHg, p=0.01), 24 hour(pCO2is 49.6 ± 9.8 mmHg and Δ pCO2is -5.8 mmHg, p=0.003) and 72 hour(pCO2is 54.8 ± 9.8 mmHg and Δ pCO2is -2.0 mmHg, p=0.026) after application of HFNC in hypercapnic group. The rate of avoidance of intubation, critical care rate and 28day mortality were not sifnificantly different between the two group(p=0.761,0.081,0.492 respectively). Conclusions: HFNC may be effective at COPD acute exacerbation patients, not only non-hypercapnic respiratory failure but also hypercapnic respiratory failure.