[The use of water to seal facial mask for non invasive ventilation reduces the incidence of pressure ulcers].
To demostrate that the use of water to seal facial mask for non invasive ventilation (NIV) reduces the incidence of facial pressure ulcers.


METHODS
prospective study including 47 pacients who (according to their responsable physician) needs NIV. Intersurgical facial mask and Puritann Bennet 7200 ventilator are used. Facial mask interface is randomly filled with water or air. Risk factors for pressure ulcers, lenght oftime of NIV (TNIV) and when the facial ulcer appears (TUA) are recorded. Student's T test is used to compare menas (except by TUA, analized with Mann-Whitney test). For qualitative variables X2 is eused. Data are presented as mean standard desviation (for TUA mean [range]).


RESULTS
We studied 23 patients in the air group (AG) and 2 patients in the water group (WG), whose mean age was 73 years and APACHE II of 13. there where no differences studied in risk factors between groups (proteins 5.6 0.8 in AG vs 5.7 1.4 g/dl; PEEP 5 2 vs 6 1 cm of water; diabetes 11 vs 10; Nasogastric tube 7 vs 6; inotropics 9 vs 6 patients). TNIV was similar between groups (884 1,092 vs 875 1,107 minutes). 39% of patients in AG and 25% in WG developed facial ulcers (p = NS), with mean TUA of 847 minutes.


CONCLUSIONS
The use of water to seal facial mask during invasive non ventilation dealays the appearance of facial ulcers. More studies are needed to demostrate significant reduction in the incidence of ulcers.
Lloys
Alba
A
Servei de Medicina Intensiva. Centre Hospitalari i Cardiològic de Manresa. Barcelona. Spain. alballoys@g2soft.com
Madrid
Carme
C
Solà
Mercè
M
Segura
Manuela
M
Tarrés
Elisabet
E
Mas
Arantxa
A
D018806:APACHE; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D003422:Critical Care; D003627:Data Interpretation, Statistical; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D008397:Masks; D008875:Middle Aged; D003668:Pressure Ulcer / Q000517:prevention & control*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods / Q000451:nursing*; D012131:Respiratory Insufficiency / Q000451:nursing* / Q000628:therapy; D012307:Risk Factors; D013997:Time Factors; D014867:Water
D014867:Water