Abstract: Objective To investigate the application value of awake prone position combined with high-flow nasal cannula oxygen therapy(HFNC) in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) presenting with mild to moderate respiratory failure. Methods A total of 60 elderly AECOPD patients with mild to moderate respiratory failure admitted to Nanjing Jiangning Hospital from January to October 2024 were enrolled in this study. All the patients were randomly divided into the observation group (n=30) and the control group (n=30). The control group was treated with HFNC, and the observation group was given awake prone position combined with HFNC. Sputum volume, oxygenation index (PaO₂/FiO₂), partial pressure of carbon dioxide (PaCO₂), modified Medical Research Council respiratory questionnaire (mMRC) score,systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and incidence of stress injury were compared between the two groups. Results On the first day of treatment, the sputum volume in the observation group was more than that in the control group (P＜0.01). After treatment, the levels of PaO₂/FiO₂, PaCO₂ and mMRC score in both groups were significantly improved compared with those before treatment (P＜0.01), especially in the observation group (P＜0.05).The level of HR in both groups was significantly lower than that before treatment (P＜0.05). There were 2 cases (6.67%) of facial stress injury in the observation group and 1 case (3.33%) in the control group, with no statistical difference between the two groups (P＞0.05). Conclusions Awake prone position combined with HFNC can effectively enhance sputum clearance, improve oxygenation index and relieve dyspnea in the elderly AECOPD patients with mild to moderate respiratory failure, and it may be worth promoting.

Key words: awake prone position, high-flow nasal cannula oxygen therapy, chronic obstructive pulmonary disease, acute exacerbation