title: Comparison of tolerance of facemask vs. mouthpiece for non-invasive ventilation.
abstract: This prospective, single centre, randomised, cross-over study compares patient tolerance of the facemask and mouthpiece for delivery of non-invasive ventilation in an intensive care unit. Twenty-seven patients with acute respiratory failure were scheduled for two 45-min sessions of non-invasive ventilation with facemask and mouthpiece. The order of the sessions was chosen at random. Nurses and patients assessed the tolerance of both techniques using a visual analogue scale. The time spent by nurses and the changes in respiratory parameters were recorded. The facemask was better tolerated than the mouthpiece; all the cases of non-invasive ventilation withdrawal (n = 5) occurred with mouthpieces (p = 0.026). Less nursing time was required using the facemask for the 22 patients who underwent both procedures (p = 0.01). However, the difference in tolerance scores was not significant. Non-invasive ventilation with both facemask and mouthpiece improved the P(a)o(2)/F(i)o(2) ratio, increased the pH and decreased the P(a)co(2). Only non-invasive ventilation with the facemask lowered the respiratory rate. The facemask appears to be a better initial choice for non-invasive ventilation when compared to mouthpiece, but both can be effective.
authors.affiliation: Department of Anaesthesia and Intensive Care, University Hospital, Hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, France.
authors.forename: E
authors.initials: E
authors.lastname: Schneider
authors.forename: C
authors.initials: C
authors.lastname: Dualé
authors.forename: J-L
authors.initials: JL
authors.lastname: Vaille
authors.forename: L
authors.initials: L
authors.lastname: Ouchchane
authors.forename: T
authors.initials: T
authors.lastname: Gillart
authors.forename: D
authors.initials: D
authors.lastname: Guélon
authors.forename: P
authors.initials: P
authors.lastname: Schoeffler
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002245:Carbon Dioxide / Q000097:blood; D003422:Critical Care / Q000379:methods / Q000523:psychology; D018592:Cross-Over Studies; D006801:Humans; D008397:Masks; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods / Q000523:psychology; D012131:Respiratory Insufficiency / Q000451:nursing / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen