|Noninvasive face mask mechanical ventilation in patients with acute hypercapnic respiratory failure.|
|PMID: 1864119 Owner: NLM Status: MEDLINE|
|Mechanically assisted intermittent positive-pressure ventilation effectively provides ventilatory support in patients with respiratory failure but it requires placing an artificial airway. We have previously reported our successful experience delivering mechanical ventilation via a face mask (FMMV) rather than with an endotracheal tube in a pilot study of patients with acute respiratory failure. The present investigation evaluated an additional 18 patients with hypercapnic respiratory failure to determine the efficacy of FMMV in a more homogeneous group and to determine factors predicting its success. FMMV was successful in avoiding intubation in 13 of the 18 patients. A significant initial improvement in PCO2 (greater than 16 percent decrease) and in pH (from less than 7.30 to greater than 7.30) predicted success. The five patients who failed on FMMV required endotracheal intubation because of inability to improve gas exchange (three patients), apnea due to sedatives (one patient), and management of secretions (one patient). FMMV was generally well accepted with only two patients withdrawn because of intolerance of the mask. The mean duration of FMMV was 25 h. Complications were seen in only two patients (11 percent): aspiration (one patient) and mild skin necrosis (one patient). Seven patients entered the study by meeting entrance criteria after an unsuccessful extubation attempt and therefore received both forms of mechanical ventilation. All but one patient avoided reintubation, and the face mask proved to be as effective as the endotracheal tube as a conduit for delivering the mechanical tidal volume and improving gas exchange. Our findings indicate that FMMV is a viable option for short-term (one to four days) ventilatory support of patients with hypercapnic respiratory failure and insufficiency.|
|G U Meduri; N Abou-Shala; R C Fox; C B Jones; K V Leeper; R G Wunderink|
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|Type: Journal Article|
|Title: Chest Volume: 100 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 1991 Aug|
|Created Date: 1991-09-06 Completed Date: 1991-09-06 Revised Date: 2004-11-17|
Medline Journal Info:
|Nlm Unique ID: 0231335 Medline TA: Chest Country: UNITED STATES|
|Languages: eng Pagination: 445-54 Citation Subset: AIM; IM; S|
|Pulmonary, and Critical Care Division, University of Tennessee, Memphis.|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Dyspnea / physiopathology
Hypercapnia / physiopathology, therapy*
Intermittent Positive-Pressure Ventilation / methods
Oxygen Inhalation Therapy / instrumentation, methods
Positive-Pressure Respiration / methods
Respiration, Artificial / instrumentation, methods*
Respiratory Insufficiency / physiopathology, therapy*
Respiratory Mechanics / physiology
Respiratory Muscles / physiopathology
Status Asthmaticus / therapy
|Chest. 1993 Apr;103(4):1304-5
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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