To investigate the efficacy of a modified respiratory support strategy on patients with chronic obstructive pulmonary disease (AECOPD) combined with type II respiratory failure.

Sixty-eight patients with AECOPD combined with type II respiratory failure who were admitted to the ICU of Huazhong University of Science and Technology Union Shenzhen Hospital in 2021-2023 were categorized into an intervention group (34 patients) and a control group (34 patients). Patients in the intervention group were treated with a modified respiratory support strategy that was dynamically adjusted to either high-flow oxygen therapy or noninvasive ventilation at 2、6、12 and 24 h post-treatment, and the control group was treated with a treatment regimen that alternated between high-flow oxygen therapy and noninvasive ventilation for 6 h. The partial pressure of arterial blood carbon dioxide (PaCO₂) and the level of decline, pH, oxygenation index, heart rate, respiratory rate, blood pressure, duration of noninvasive ventilation, dyspnea score, comfort score, diaphragm movement and 28-day survival rate were compared between the two groups.

There were no significant differences in baseline characteristics between the two groups, and the differences in PaCO₂, pH, PaO₂, oxygenation index, and heart rate, respiration rate, and blood pressure obtained at any of the study time points were not statistically significant (P>0.05). The duration of noninvasive ventilation in the intervention group was significantly lower than that in the control group over a 24 h period (4.53±8.10 vs. 12.00±0.00, P<0.001), and the intervention group had lower dyspnea scores and higher comfort scores (P=0.003, 0.010, respectively).

In the treatment of patients with AECOPD combined with type II respiratory failure, the modified respiratory support strategy not only effectively reduces PaCO₂, but also decreases the duration of noninvasive positive pressure ventilation, alleviates the symptoms of dyspnea, and improves patient comfort.