Chest
Original ResearchCritical CareEvaluation of the Total Face Mask for Noninvasive Ventilation to Treat Acute Respiratory Failure
Section snippets
Performance Sites
The study was performed at Tufts Medical Center, Boston, Massachusetts, and Rhode Island Hospital, Providence, Rhode Island, and was approved by the institutional review boards at each institution (approval numbers 6060 and 0198-01, respectively). At Tufts Medical Center, the study was deemed to add minimal risk, and a consent waiver was granted. Informed consent was obtained from patients or their proxies at Rhode Island Hospital.
Patients
Patients ≥ 18 years old with acute respiratory distress
Baseline Characteristics
Of 66 patients screened for enrollment, six patients were excluded (Fig 4). Baseline characteristics did not differ significantly between the two groups (Table 1), except for a higher heart rate in the TFM group. Patients in the TFM group tended to have more COPD exacerbations and those in the ONM group more pneumonia, but these differences were not statistically significant (Table 2). Three patients in the ONM group and four patients in the TFM group previously received home NIV therapy using
Discussion
The key findings of this study are that the TFM and the ONM (1) are perceived as similarly comfortable by patients with ARF receiving NIV, (2) require similar amounts of time for placement, and (3) are associated with similar early NIV discontinuation rates, although the TFM tends to be associated with intolerance and poor fit more often than does the ONM.
Mask type can be a major factor affecting patient comfort and adherence to therapy during NIV.13, 14, 15, 27, 28, 29 Using a randomized
Conclusions
In summary, our study demonstrates that the TFM does not offer significant advantages over the ONM. espite the trend towards more early discontinuations because of mask intolerance with the TFM than with the ONM, the TFM performed as well as the ONM with regard to other major outcomes, such as avoiding intubation, and mortality, and should be considered a possible alternative when very rapid application is desired or when nasal ulcers or intolerance complicate the use of ONM.
Acknowledgments
Author contributions: Dr Ozsancak: contributed to study design, data acquisition and analysis, and preparation of the manuscript.
Dr Sidhom: contributed to study design, data acquisition and analysis, and preparation of the manuscript.
Dr Liesching: contributed to study design, data acquisition and analysis, and preparation of the manuscript.
Mr Howard: contributed to data acquisition and analysis and preparation of the manuscript.
Dr Hill: contributed to study design, data acquisition and
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Funding/Support: This study was partially funded by research grants from Respironics, Inc (Dr Hill).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).