Efficacy of a New Full Face Mask for Noninvasive Positive Pressure Ventilation: Discussion
There was a significant improvement in gas exchange short term during NPPV with all three masks; however, the reduction in PaCC>2 was greatest when NPPV was delivered with the TFM.
This is attributed to the observation that the increases in expired tidal volume and minute ventilation were greatest with the use of the total face mask. In addition, dyspnea, discomfort with the face mask, and level of mask or mouth leaks were least during NPPV with the TFM compared with the N or NO masks. Moreover, there was a significant improvement in gas exchange and functional status with daily use of NPPV with the TFM and this improvement was sustained over the period of follow-up asthma inhaler.
The results of our study demonstrate that NPPV via a TFM is an effective way of delivering noninvasive ventilation while simultaneously minimizing the development of mask leaks and improving patient comfort. Similarly, this form of face mask is much easier to use and is less likely to become dislodged or need frequent readjustment to maintain an adequate seal.
Because the TFM covers the entire face, one would think that this would worsen feelings of claustrophobia rather than improve it. However, in three patients in whom claustrophobia limited tolerance of the NO mask, this sensation was avoided with the use of the TFM. Potential explanations for the reduction in claustrophobia while using the TFM include the following: an unobstructed patient field of vision; the ability to verbally communicate; and the sensation of air flowing over the entire face while using the mask.
Conceivably, allowing the patients to see and verbally communicate while in the TFM may have lessened the patient’s feelings of isolation, and further improved the patient’s tolerance of noninvasive ventilation. Many patients with pulmonary conditions express a subjective decrease in the sensation of dyspnea when cold or flowing air is directed to the face. Breathless patients commonly request a fan or to be placed near an open window to alleviate breathlessness.
Category: Respiratory Symptoms
Tags: face mask, hypercapnia, noninvasive ventilation, respiratory failure