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Nasal versus full face mask for noninvasive ventilation in chronic respiratory failure

¹ Centre for Respiratory Failure and Sleep Disorders, Royal Prince Alfred Hospital, ² Woolcock Institute of Medical Research and³ David Read Laboratory, Dept of Medicine, University of Sydney, Sydney, Australia

CORRESPONDENCE: G.N. Willson, Centre for Respiratory Failure and Sleep Disorders, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia. Fax: 61 295157196. E-mail: gnw@galen.med.usyd.edu.au

Keywords: mask interfaces, mechanical ventilation, noninvasive ventilation, respiratory insufficiency, sleep apnoea syndromes

Received: May 9, 2003
Accepted November 11, 2003

G.N. Willson and A.J. Piper are consultants to ResMed Ltd. A.J. Piper holds options in ResMed Ltd.

This study was undertaken to determine the efficacy of nasal mask (NM) versus full face mask (FFM) for the delivery of noninvasive ventilation (NIV) in subjects with nocturnal hypoventilation.

A total of 16 patients (11 males) were enrolled, all with nocturnal hypoventilation currently treated at home with NIV via pressure preset devices. Subjects underwent full polysomnography on three occasions; on the first night current therapy on NM was reviewed, followed by two experimental studies in randomised order using either NM or FFM. NIV settings and oxygen flow rate were the same under both conditions. Notably, 14 of the 16 subjects required the use of a chinstrap to minimise oral leak.

Apnoea-hypopnoea indices were within normal limits under both conditions (1.7±3.4 NM versus 1.6±2.4 h FFM). The type of interface did not significantly affect gas exchange during sleep (minimum average arterial oxyhaemoglobin saturation total sleep time 93.4±2.1 NM versus 92.8±2.5% FFM, Delta transcutaneous carbon dioxide nonrapid eye movement sleep to rapid eye movement sleep (0.58±0.36 NM versus 0.50±0.40 kPa FFM). Sleep efficiency was significantly reduced on the FFM (78±9 NM versus 70±14% FFM), although arousal indices were comparable under both conditions (15.6±9.8 NM versus 15.8±8.8 h FFM).

Full face masks appear to be as effective as nasal masks in the delivery of noninvasive ventilation to patients with nocturnal hypoventilation. However, a chinstrap was required to reduce oral leak in the majority of subjects using the nasal mask.

This article has been cited by other articles:

				G.N. Willson, A.J. Piper, and R.R. Grunstein From the authors Eur. Respir. J., October 1, 2004; 24(4): 709 - 709. [Full Text] [PDF]

				P. Wijkstra Nasal versus full face mask for noninvasive ventilation in chronic respiratory failure Eur. Respir. J., October 1, 2004; 24(4): 708 - 709. [Full Text] [PDF]