Efficacy of a New Full Face Mask for Noninvasive Positive Pressure Ventilation: Finally
Mask or mouth leaks may also have a negative effect on gas exchange and impair the effectiveness of NPPV in avoiding endotracheal intubation. In studies examining NPPV in acute respiratory failure, inability to improve gas exchange, or poor patient tolerance of the mask, results in 10 to 50 percent of patients failing therapy and requiring endotracheal intubation.” Improvements in face mask design that improve patient tolerance and increase alveolar ventilation by minimizing leaks may have a significant impact on NPPV being successful in patients with acute respiratory failure. Recently, in two of our patients, noninvasive ventilation with the TFM was used in the ICU when the patients originally presented in acute respiratory failure birth control online.
Although, N and NO masks were poorly tolerated by these two patients because of feelings of claustrophobia, significant mouth leaks, and patient-ventilation dyssyn-chrony, noninvasive ventilation via the TFM was easily applied, was well tolerated by the patients, and was not complicated by significant leaks even when used for extended periods of time (ie, continuously for 10 to 12 h). In one of the two patients, noninvasive ventilation via the TFM was possible despite the presence of a nasogastric tube for administration of medications without adversely affecting the patient mask seal.
In summary, we have shown that NPPV via a TFM in selected patients with chronic respiratory failure may improve comfort, minimize air leakage from the mask-face interface, and improve alveolar ventilation. Furthermore, we suggest that this form of mask may be effective in patients suffering from acute respiratory failure who are candidates for noninvasive mechanical ventilation in a controlled environment such as the ICU. As our data show, the face mask used for noninvasive ventilation may have an important impact on the degree of face mask or mouth leaks, patient tolerance, and overall efficacy of noninvasive ventilation. Additional larger, prospective, and randomized clinical trials using the various forms of face masks are currently needed to confirm the most effective mask for delivering NPPV.
Category: Respiratory Symptoms
Tags: face mask, hypercapnia, noninvasive ventilation, respiratory failure