Document Detail


Controlled trial of oronasal versus nasal mask ventilation in the treatment of acute respiratory failure.
MedLine Citation:
PMID:  12576953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Noninvasive positive pressure techniques such as continuous and bilevel positive airway pressure avoid intubation and its attendant complications in selected patients with acute respiratory failure. However, mask intolerance remains a common cause for failure of noninvasive ventilatory techniques. The aim of our study was to assess patient tolerance of oronasal vs. nasal mask ventilation in acute respiratory failure. DESIGN: Randomized, controlled trial. SETTING: Emergency department or intensive care units at a university hospital. PATIENTS: Seventy patients with acute respiratory failure as evidenced by clinical or blood gas criteria. INTERVENTIONS: Patients randomly received either a disposable nasal or an oronasal mask (Respironics, Pittsburgh, PA) when they met study criteria. MEASUREMENTS AND MAIN RESULTS: Thirty-five patients were randomized into each arm of the study; most of the patients had acute cardiogenic pulmonary edema (48.6% of the nasal mask group and 42.8% of the facial mask group) or chronic obstructive airway disease (34.3% of the nasal mask group and 31.4% of the facial mask group). Baseline clinical characteristics of the two groups of patients were similar. Heart and respiratory rates and blood gases improved similarly for patients in both mask groups. Rates of intubation were also similar (eight in each group). However, mask intolerance was significantly higher in the nasal than the oronasal mask group (12 vs. 4, respectively, p=.023). Four patients in the nasal (11.4%) and two in the oronasal mask group (5.7%) died later during the hospitalization. The overall success rate tended to be greater in the oronasal (65.7%) than the nasal group (48.6%), but the difference was not statistically significant. CONCLUSION: Although both masks performed similarly with regard to improving vital signs and gas exchange and avoiding intubation, the nasal mask was less well tolerated than the oronasal mask in patients with acute respiratory failure.
Authors:
Henry Kwok; James McCormack; Richard Cece; Jeanne Houtchens; Nicholas S Hill
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-10     Completed Date:  2003-03-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  468-73     Citation Subset:  AIM; IM    
Affiliation:
Rhode Island Hospital and Brown University School of Medicine, Providence, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Equipment Design
Female
Humans
Male
Masks*
Mouth
Nose
Respiration, Artificial / instrumentation*
Respiratory Insufficiency / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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