6/28/23, 12:03 AM AECOPD Pathway Feedback Search Clinical Topics Home Studies AECOPD AECOPD Disease Chronic obstructive pulmonary Trial question Is high-flow nasal cannula superior to conventional oxygen therapy in patients with acute COPD exacerbation and mild hypercapnia? Study design Multi-center Open label RCT Population Characteristics of study participants 16.0% female N = 330 84.0% male 330 patients (53 female, 277 male) Inclusion criteria: patients with acute COPD exacerbation and mild hypercapnia Key exclusion criteria: age > 85 years; Glasgow coma scale score < 12; obstructive sleep apnea syndrome; excessive airway secretions difficult to drain; hemodynamic instability; severe arrhythmia or acute coronary syndrome; respiratory and cardiac arrest Interventions N=158 high-flow nasal cannula (oxygen flow rate set at 25-60 L/min) N=172 conventional oxygen therapy (oxygen flow rate set at 1-5 L/min) Primary outcome https://web.pathway.md/studies/recq8ojP3oIbZalVd 1/2 6/28/23, 12:03 AM AECOPD Pathway Percentage of patients who needed intubation 2.5 % 2.5 1.9 % 1.3 % Significant increase 0.6 % 0.6 NNH = 53 0.0 % High-flow nasal cannula Conventional oxygen therapy Significant increase in the percentage of patients who needed intubation (2.5% vs. 0.6%; AD 1.95%, 95% CI 0.8 to 4.7) Secondary outcomes No significant difference in noninvasive positive pressure ventilation (9.5% vs. 12.8%; ARD -3.3, 95% CI -10.1 to 3.5) Significant increase in length of hospital stay (9 days vs. 8 days; AD 1 days, 95% CI 0 to 2) No significant difference in treatment failure (15.8% vs. 14.5%; AD 1.29%, 95% CI -6.5 to 9) Safety outcomes No significant differences in death in the hospital, re-admission to the hospital. Conclusion In patients with acute COPD exacerbation and mild hypercapnia, high-flow nasal cannula was not superior to conventional oxygen therapy with respect to the percentage of patients who needed intubation. Reference Jingen Xia, Sichao Gu, Wei Lei et al. High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial. Crit Care. 2022 Apr 15;26(1):109. Open reference URL https://web.pathway.md/studies/recq8ojP3oIbZalVd 2/2