• AECOPD
• Xuanbai Chengqi decoction
• clinical efficacy
• phlegm-heat obstructing lung syndrome

• Humans
• Drugs, Chinese Herbal/therapeutic use
• Male
• Female
• Retrospective Studies
• Middle Aged
• Treatment Outcome
• Aged
• Medicine, Chinese Traditional
• Syndrome
• Drug Therapy, Combination

• Acute attacks of COPD
• Acute exacerbation
• COPD
• Inflammation
• Inflammatory biomarkers
• Inflammatory cytokines
• Inflammatory mediators
• Novel biomarkers
• Pathogenesis of COPD
• Pathophysiology of COPD

• Humans
• Pulmonary Disease, Chronic Obstructive/diagnosis
• Pulmonary Disease, Chronic Obstructive/metabolism
• Biomarkers/analysis
• Prognosis

• chronic obstructive pulmonary disease
• clinical practice guideline
• integrative medicine

• Humans
• Medicine, Chinese Traditional
• Pulmonary Disease, Chronic Obstructive/therapy
• Pulmonary Disease, Chronic Obstructive/drug therapy

• 2018YFC1704802 National Key Research & Development Program of China
• [2020]219 Inheritance and Innovation BaiQianWan Talents Project-Chief Scientist Project of Qihuang Project
• ZYYCXTD-C-202206 Administration of Traditional Chinese Medicine of China: Traditional Chinese Medicine Inheritance and Innovation Team Project

Most patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) have respiratory failure that necessitates active correction and the improvement of oxygenation is particularly important during treatment. High flow nasal cannula (HFNC) oxygen therapy is a non-invasive respiratory aid that is widely used in the clinic that improves oxygenation state, reduces dead space ventilation and breathing effort, protects the loss of cilia in the airways, and improves patient comfort.

To compare HFNC and non-invasive positive pressure ventilation in the treatment of patients with AECOPD.

Eighty AECOPD patients were included in the study. The patients were in the intensive care department of our hospital from October 2019 to October 2021. The patients were divided into the control and treatment groups according to the different treatment methods with 40 patients in each group. Differences in patient comfort, blood gas analysis and infection indices were analyzed between the two groups.

After treatment, symptoms including nasal, throat and chest discomfort were significantly lower in the treatment group compared to the control group on the 3^rd and 5^th days (P < 0.05). Before treatment, the PaO₂, PaO₂/FiO₂, PaCO₂, and SaO₂ in the two groups of patients were not significantly different (P > 0.05). After treatment, the same indicators were significantly improved in both patient groups but had improved more in the treatment group compared to the control group (P < 0.05). After treatment, the white blood cell count, and the levels of C-reactive protein and calcitonin in patients in the treatment group were significantly higher compared to patients in the control group (P < 0.05).

HFNC treatment can improve the ventilation of AECOPD patients whilst also improving patient comfort, and reducing complications. HFNC is a clinically valuable technique for the treatment of AECOPD.

• Acute exacerbation chronic obstructive pulmonary disease
• HFNC
• Noninvasive positive pressure ventilation
• Application value

• Humans
• Remission Induction
• Systematic Reviews as Topic
• Leukemia, Myeloid, Acute/therapy
• Hematopoietic Stem Cell Transplantation/methods
• Recurrence

How to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explore the clinical significance of taking the change rate of procalcitonin (PCT) as identifying the timing of weaning on the mechanical ventilation for the patients of AECOPD followed by ARF as a complication. There were altogether 140 patients of AECOPD complicated with ARF, who were randomly selected and divided into a study group and a control group respectively. A change rate of serum PCT level exceeding 50% was taken as the switch point selection of tracheal intubation removal for the patients of the study group, while the ‘pulmonary infection control (PIC) window’ was done for those in the control group. With CRP, IL-6, TNF-a, PaCO_2, PaO_2, and Lac having been detected before and after treatment to them all, clinical indexes were obtained and compared between these two groups. The CRP, TNF-a, and IL-6 levels of the patients in the study group after treatment (p < 0.05) were lower than those in the control group. There was no significant difference in PaCO_2, PaO_2, and Lac between these two groups before and after treatment (p > 0.05). Even so, some other indexes available for the study group of patients were found to be lower than those for the control group (p < 0.05) in the following aspects: duration of invasive ventilation support, total time of mechanical ventilation support, incidence rate of ventilator-associated pneumonia, 48-hour reintubation rate, incidence rate of upper gastrointestinal bleeding, hospitalization time of critical respiratory illness, total hospitalization time, RICU treatment cost, total treatment cost, and mortality. It is preferable to take the change rate of PCT level exceeding 50% as the switch point of weaning time in sequential mechanical ventilation rather than the PIC window.

Abbreviations

AECOPD: acute exacerbation of chronic obstructive pulmonary disease; ARF: acute respiratory failure; PCT: procalcitonin; PaO₂: the oxygen partial pressure; PaCO₂: the partial pressure of carbon dioxide; TNF-a: serum tumor necrosis factor-a; IL-6: interleukin-6; CRP: serum C-reactive protein; PIC window: pulmonary infection control window; RICU: respiration and intensive care unit

• Acute respiratory failure
• invasive ventilation support therapy
• kinetics
• procalcitonin
• pulmonary infection control window
• timing of weaning