RT Journal Article
SR Electronic
T1 Could facial interface have an impact on efficacy of non-invasive ventilation (NIV)?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3728
VO 42
IS Suppl 57
A1 Caroline Abdulmalak
A1 Claudio Rabec
A1 Marjolaine Georges
A1 Thomas Maitre
A1 Ntumba Kabeya
A1 Adeline Metchedjin
A1 Philippe Camus
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3728.abstract
AB Nasal (NM) or facial (FM) masks could be used to provide CPAP and NIV treatment. Nevertheless, FM may not be effective in a subset of patients (p) with sleep apnea¹. In a cohort study we compared the efficacy of NM and FM in a subset of p initially treated by FM in whose obstructive events (OE) persisted despite a high level of expiratory pressure.MethodsWe randomly performed a polysomnography (PSG) on NM and FM in patients primarily treated by FM and in whose OE persisted despite pressure ≥ 12cm H2O in p on CPAP, or EPAP ≥ 10 cm H20 in those on bilevel or assisted servo ventilation (ASV). In patients on CPAP, both PSG were performed by using an AutoCPAP mode (6-18 cm), whereas in NIV and ASV p, EPAP was set at currently used levels.ResultsWe included 54 p (age 74±2.9, BMI 33±2.4, 32 M / 22 F, basal AHI 55±9.4) fulfilling the inclusion criteria (35 on CPAP, 17 on bilevel, 2 on ASV). 9 p were excluded (5 reject to participate, 4 did not tolerate NM). Among the 45 remaining, 33 showed a significant difference in AHI between both masks (total: FM 44±17, NM 9±0.6; OE: FM 37±2, NM 4.4±2.4 p<0.0001). Arousal index was also significantly higher with FM than with NM (32.4±1.5 vs 11.5±1.6 p<0.0001), while sleep efficiency didn’t vary significantly between both nights. In CPAP patients, effective pressure (P95) was also significantly higher with FM (FM 18±0.2, NM 13.9±0.3 p<0.0001), while mean leaks (l/sec) were similar with both masks (FM 3.5±0.4, NM 3.8±0.4). When p showing differences between masks were compared with those without, age, BMI and sex were similar.ConclusionThis study suggest that, in a subset of patients, FM can impact the efficacy of both CPAP and NIV¹ Schorr, Eur Resp J 2013:40; 503.