Abstract:

Objective  To investigate the application value of awake prone position combined with high-flow nasal cannula oxygen therapy（HFNC) in elderly acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients 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 selected as the research objects. All the patients were randomly divided into an observation group (n=30) and a control group (n=30). The control group was treated with HFNC, and the observation group was given HFNC combined with awake prone position. Sputum volume, respiratory related indexes [oxygenation index (PaO₂/FiO₂), partial pressure of carbon dioxide (PaCO₂) and modified Medical Research Council (mMRC) respiratory questionnaire score], blood pressure related indexes [systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)] and incidence of stress injury were compared between the two groups. Results  After treatment, the sputum output of the observation group was more than that of 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 of before treatment (P＜0.01), especially in the observation group (P＜0.05). SBP and DBP in both groups had no significant change compared with those before treatment(P＞0.05)，while HR in both groups were significantly lower than those 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 significance between the two groups (P＞0.05).Conclusion  Awake prone position combined with HFNC can effectively enhance sputum clearance, improve oxygenation index and relieve dyspnea in 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')">

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