TY - JOUR T1 - High flow nasal cannula (HFNC) vs. non-invasive ventilation in OHS with severe pneumonia patients: A prospective study JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.sleepandbreathing-2021.53 VL - 7 IS - suppl 7 SP - 53 AU - B Han AU - L Yue AU - M Tian AU - J Chang AU - H Liu AU - Y Hao AU - G Hou AU - B Li Y1 - 2021/04/16 UR - http://openres.ersjournals.com/content/7/suppl_7/53.abstract N2 - Objective:To compare the clinical outcomes of HFNC with non-invasive ventilation(NIV) with auto-titrating EPAP for severe pneumonia patients with OHS(obesity hypoventilation syndrome).Methods:It was a prospective, randomized and controlled study. 60 severe pneumonia patients with OHS (27.3±8.9 yrs,BMI:40±8.9 kg/m2) were included, who had no a history of immunosuppressant therapy. Main criteria: 100<PO2/FiO2<300 mmHg; APACHE-Ⅱ:20-30. All subjects were randomly divided (1:1:1) into three groups: HFNC-group(Flow:50-60L/min,FiO2:40-60%); AVAPS- group (NIV with AVAPS mode, EPAP=8 cmH2O) and AVAPS-AE (average volume assured pressure support auto-titrating EPAP)group: AVAPS-AE mode, maximum EPAP=14cmH2O,minimum EPAP=4cmH2O.Results:Higher occurrence of ventilator-induced lung injury(VILI) and patient-ventilator asynchrony were observed in AVAPS-group than in other groups (p<0.001) .28-day mortality rates of 20.0%(n=4) in HFNC–group was significantly lower than in 45% (n=9) in “AVAPS-group and 30% (n=6) in AVAPS- AE group(p<0.05). There were no significant differences in changes of PO2/FiO2 between AVAPS-AE and AVAPS group(p>0.05). Degree of the comfortable during NIV in AVAPS-AE group were higher than in AVAPS group(p<0.05).Conclusions:Young OHS patients with severe pneumonia maybe could not benefit from noninvasive ventilation, either AVAPS or AVAPS-AE mode, and there were high mortality rate in both groups. HFNC seems to be superior to NIV in increasing VILI and 28-day mortality rate. AVAPS-AE mode could improve the patient’s comfort by auto-titrating EPAP level.FootnotesCite this article as ERJ Open Research 2021; 7: Suppl. 7, 53.This is an ERS Lung Science Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -