PT - JOURNAL ARTICLE AU - Caroline Abdulmalak AU - Claudio Rabec AU - Marjolaine Georges AU - Thomas Maitre AU - Ntumba Kabeya AU - Adeline Metchedjin AU - Philippe Camus TI - Could facial interface have an impact on efficacy of non-invasive ventilation (NIV)? DP - 2013 Sep 01 TA - European Respiratory Journal PG - P3728 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/P3728.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/P3728.full SO - Eur Respir J2013 Sep 01; 42 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.