Comparison of Comfort and Effectiveness of Total Face Mask and Oronasal Mask in Noninvasive Positive Pressure Ventilation in Patients with Acute Respiratory Failure: A Clinical Trial

Abstract

Background. There is a growing controversy about the use of oronasal masks (ONM) or total facemask (TFM) in noninvasive positive pressure ventilation (NPPV), so we designed a trial to compare the uses of these two masks in terms of effectiveness and comfort. Methods. Between February and November 2014, a total of 48 patients with respiratory failure were studied. Patients were randomized to receive NPPV via ONM or TFM. Data were recorded at 60 minutes and six and 24 hours after intervention. Patient comfort was assessed using a questionnaire. Data were analyzed using t-test and chi-square test. Repeated measures ANOVA and Mann–Whitney U test were used to compare clinical and laboratory data. Results. There were no differences in venous blood gas (VBG) values between the two groups (P > 0.05). However, at six hours, TFM was much more effective in reducing the partial pressure of carbon dioxide (PCO2) (P = 0.04). Patient comfort and acceptance were statistically similar in both groups (P > 0.05). Total time of NPPV was also similar in the two groups (P > 0.05). Conclusions. TFM was superior to ONM in acute phase of respiratory failure but not once the patients were out of acute phase.

Non‐invasive ventilation practices in children across Europe

“…The new total face masks are specifically designed for young children and, as the interface plays an essential role in tolerance and synchronization, this could have an impact in future NIV outcomes . To our knowledge, no studies in children have compared the use of total face masks with oronasal ones, although adult studies have suggested some advantages of total face interfaces over oronasal masks …”

“…27 To our knowledge, no studies in children have compared the use of total face masks with oronasal ones, although adult studies have suggested some advantages of total face interfaces over oronasal masks. 28 Helmet interface was frequently used in some Southern European Ineffective triggering is the major cause of asynchrony in infants. [31][32][33] We hypothesize that this may be the main reason why A-PCV (pressure controlled continuous mandatory ventilation with set point targeting scheme 34 ) was more frequently used in infants requiring bilevel NIV than in older children.…”

Choosing the Proper Interface for Positive Airway Pressure Therapy in Subjects With Acute Respiratory Failure

“…A recent study randomly assigned 48 subjects with ARF into groups using an oro-nasal mask or a total face mask and monitored responses for 24 h. 15 At 6 h, use of a total face mask was significantly more effective in reducing P aCO 2 (P ϭ .04). However, there was no difference between the 2 masks once subjects cleared the acute phase.…”

“…Acceptance and comfort were similar in both groups. 15 Because mouth breathing is prevalent in patients with ARF, a face mask (oro-nasal or total face mask) is considered to be the most suitable and effective interface, followed by a nasal mask and a mouthpiece. 10,12,13 Therefore, the most commonly used interface in patients with ARF is the oronasal mask.…”

Performance of Noninvasive Ventilation Masks in a Lung Model of COPD Exacerbation

“…8 The mask used to deliver NIV can result in variable rates of air leaks, 9,10 CO 2 rebreathing, tidal volume (V T ), and patient-ventilator synchrony, all of which can increase the work of breathing and lead to progressive respiratory failure. [11][12][13] Historically, masks that cover the mouth, nose, or both have been used to treat ARF, 9,14 until masks that cover larger surfaces of the face were available, with similar efficiency and more comfort. 15,16 These larger-volume total face masks reduce the respiratory rate, 17 use of accessory muscles, and P CO 2 14,17 when compared with oronasal masks, without clear superiority in terms of clinical outcomes.…”