title: Continuous noninvasive ventilation delivered by a novel total face mask: a case series report.
abstract: Noninvasive ventilation (NIV) has been widely used to decrease the complications associated with tracheal intubation in mechanically ventilated patients. However, nasal ulcerations may occur when conventional masks are used for continuous ventilation. A total face mask, which has no  contact with the more sensitive areas of the face, is a possible option. We describe 3 patients with acute respiratory failure due to amyotrophic lateral sclerosis, who developed nasal bridge skin necrosis during continuous NIV, and one patient with post-extubation respiratory failure due  to a high spinal cord injury, who had facial trauma with contraindication for conventional mask use. The total face mask was very well tolerated by all the patients, and permitted safe and efficient continuous NIV for several days until the acute respiratory failure episode resolved. None  of the patients required endotracheal intubation during the acute episode.
authors.affiliation: Pulmonary Medicine Department, University Hospital of Sao Joao, Porto, Portugal. inesbelchior@gmail.com
authors.forename: Inês
authors.initials: I
authors.lastname: Belchior
authors.forename: Miguel R
authors.initials: MR
authors.lastname: Gonçalves
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Winck
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008397:Masks; D008875:Middle Aged; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods*; D013119:Spinal Cord Injuries / Q000628:therapy*