BACKGROUND: The aim of this study is to investigate the therapeutic effects of a non-invasive ventilator combined with bronchodilator and anti-infective drugs in the treatment of 45 cases of chronic respiratory failure. METHODS: 45 chronic respiratory failure patients who were hospitalized to our hospital between August 2019 and January 2022 were chosen as research subjects. They were randomly allocated into two groups using the random number table approach, the control group (n = 21) and the observation group (n = 24), and they were given numbers according to the sequence of treatment. Treatment as usual was given to the control group. The observation group was further treated with a bronchodilator (tiotropium bromide) and an anti-infective drug (piperacillin). The curative effect of each group after treatment was observed and compared. RESULTS: After running a statistical analysis on demographic information from both groups, including gender, age, BMI, and disease severity, the results showed no significant difference between the groups (P >
0.05). There was a statistically significant (P <
0.05) difference between the observation group and the control group in terms of the time it took for temperatures to recover and pulmonary rales to disappear, as well as the time it took for asthma attacks to occur. Prior to therapy, there were no statistically significant differences between the two groups on blood gas indices or inflammatory indices (P >
0.05). After therapy, patients in the experimental group had lower levels of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) compared to the controls. The oxygenation index and bacterial partial pressure of oxygen (PaO2) were both considerably higher in the experimental group compared to the control group (P <
0.05). There was no significant difference between the two groups' baseline values for any of the lung function indices (P >
0.05). Following treatment, patients in the treated group had significantly higher forced vital capacity (first second forced vital capacity, first second forced vital capacity, contents of FEV1), forced expiratory volume at first second to forced vital capacity (FEVl/FVC), and forced expiratory volume at first second to predicted value (FEV1% predicted value) compared to those in the control group. This difference was statistically significant (P <
0.05). There was a statistically significant (P <
0.05) improvement in clinical efficacy between the observation group and the control group. In neither group did any patients stop taking the medication due to unwanted side effects. CONCLUSION: A noninvasive ventilator combined with tiotropium bromide and piperacillin has accurate efficacy in the treatment of patients with chronic respiratory failure, which can improve the indexes of arterial blood gas and lung function, reduce inflammatory response, promote disease recovery and have high safety.