title: Nasal versus oronasal mask in home mechanical ventilation: the preference of patients as a strategy for choosing the interface.
abstract: BACKGROUND
  In home mechanical ventilation (HMV), the mask is a key factor for patient comfort and therapeutic adherence. There is no evidence on the best strategy for choosing the mask in HMV.
  
  
  OBJECTIVE
  To explore patient preference when prescribing the mask for HMV treatment and  assess its relationship with effectiveness.
  
  
  METHODS
  A prospective study with repeated measures in stable patients receiving home nocturnal ventilation. Alternating oronasal mask (ONM) and nasal mask (NM) were tested in day and overnight sessions, with arterial blood gas measured and S(pO(2))  monitored. At the end of each evening session, patients rated interface comfort using a visual analog scale. At 3 months we evaluated adherence and effectiveness of the treatment.
  
  
  RESULTS
  Twenty-nine subjects (mean ± SD age 65 ± 13 y, 44% male) completed the study. Initial functional  values were P(CO(2)) 57.4 ± 5.2 mm Hg and time with S(pO(2)) < 90% (T90) 81.5 ± 9.5%. Both ONM and NM significantly decreased P(CO(2)) and T90. Over a third (38%) of our subjects preferred ONM, while NM was deemed more  comfortable in general. At 3 months, effectiveness and adherence showed no differences between those treated with NM or ONM.
  
  
  CONCLUSIONS
  Patient choice is an effective criterion for selecting the interface in HMV treatment.
authors.affiliation: Servicio de Neumologia, Hospital Universitario Central de Asturias, Facultad de Medicina Universidad de Oviedo, Oviedo, Asturias, Spain. enelllano@gmail.com
authors.forename: Ramón
authors.initials: R
authors.lastname: Fernandez
authors.forename: Cristina
authors.initials: C
authors.lastname: Cabrera
authors.forename: Gemma
authors.initials: G
authors.lastname: Rubinos
authors.forename: Ana
authors.initials: A
authors.lastname: Pando
authors.forename: Rosa
authors.initials: R
authors.lastname: Galindo
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodríguez
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez
authors.forename: Isidro
authors.initials: I
authors.lastname: Gonzalez
authors.forename: Pere
authors.initials: P
authors.lastname: Casan
mesh_terms: D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D016009:Chi-Square Distribution; D002755:Choice Behavior; D005260:Female; D006801:Humans; D008297:Male; D008397:Masks; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000628:therapy; D010845:Obesity Hypoventilation Syndrome / Q000628:therapy; D010349:Patient Compliance; D057240:Patient Preference; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D018709:Statistics, Nonparametric; D035441:Thoracic Wall / Q000503:physiopathology