Application of non-invasive mechanical ventilation with different oxygen concentrations in patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure

Objective To investigate the influence of different fractions of inspired oxygen used in non-invasive mechanical ventilation on blood gas parameters and serum high mobility group box-1 (HMGB1) and interleukin-27 (IL-27) levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type Ⅱ respiratory failure.

Methods A total of 152 patients with AECOPD and type Ⅱ respiratory failure were selected as the subjects of the study and divided into group A (n=76) and group B (n=76) using a random number table method. The fraction of inspired oxygen used in non-invasive mechanical ventilation in the group A was 45%, while was 60% in the group B. The changes in blood gas parameters, serum HMGB1 and IL-27 levels at different time points were compared between the groups; the occurrence of complications during treatment was recorded.

Results After 7 days of treatment, the arterial oxygen partial pressure p_a(O₂) and pH levels in the group A were significantly higher than those in the group B, while the arterial carbon dioxide partial pressure p_a(CO₂) level was significantly lower than that in the group B (P < 0.05). After 1 day and 7 days of treatment, the serum HMGB1 and IL-27 levels in the group A were significantly lower than those in the group B (P < 0.05). During the treatment period, there was no significant difference in the overall incidence of complications between the two groups (P>0.05).

Conclusion Compared with 60% inhaled oxygen concentration, AECOPD patients with type Ⅱ respiratory failure receiving non-invasive mechanical ventilation with an inhaled oxygen concentration of 45% have better clinical outcomes. The patients' blood gas indicators, serum HMGB1 and IL-27 levels are significantly improved, and the treatment is relatively safe.