To observe the clinical effect of the acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients complicated with respiratory failure after different Sequential off-line (noninvasive positive pressure ventilation and noninvasive positive pressure ventilation combined with high-flow oxygen group).

48 patients over 60 years old with AECOPD treated by invasive mechanical ventilation. Patients were divided into two groups at random: 25 cases of group A (Non-invasive positive pressure ventilation sequential group) and 23 cases of group B (Non-invasive positive pressure ventilation combined with high-flow oxygen sequential group). Two groups received conventional treatment. According to daily SBT results and clinic experience, treatment team evaluated weaning. Group A treated by noninvasive positive pressure ventilation sequential therapy after weaning, Group B treated by noninvasive positive pressure ventilation combined with high flow oxygen sequencing. General information, clinical manifestation (age, sex, APACHE Ⅱ score, underlying diseases, SOFA score), vital signs and blood gas index (heart rate, breath, systolic pressure, oxygen partial pressure, partial pressure of carbon dioxide) after extubation (4 h, 8 h, 12 h, 24 h and 48 h), prognostic index (invasive positive pressure ventilation time), reintubation rate within and after 48 hours, duration of ICU stay, 28-day and 90-day mortality) were observed and recorded.

There was no significant statistical difference in demography, clinical data, the duration of Invasive mechanical ventilation, reintubation rate within and after 48 hours, 28-day and 90-day mortality between two groups (P>0.05). Group B had a shorter duration of ICU stay than group A (P<0.05), showing a statistical difference.

Noninvasive positive pressure ventilation combined with high-flow oxygen sequencing shortened the duration of ICU stay.