Intensive Care Medicine

, 35:519

Cephalic versus oronasal mask for noninvasive ventilation in acute hypercapnic respiratory failure

  • Antoine Cuvelier
  • Wilfried Pujol
  • Stéphanie Pramil
  • Luis Carlos Molano
  • Catherine Viacroze
  • Jean-François Muir
Original

DOI: 10.1007/s00134-008-1327-x

Cite this article as:
Cuvelier, A., Pujol, W., Pramil, S. et al. Intensive Care Med (2009) 35: 519. doi:10.1007/s00134-008-1327-x

Abstract

Objective

Compared to oronasal interfaces, a cephalic mask has a larger inner volume, covers the entire anterior surface of the face and limits the risk of deleterious cutaneous side effects during noninvasive ventilation (NIV). The present clinical study aimed to compare the clinical efficacy of a cephalic mask versus an oronasal mask in patients with acute hypercapnic respiratory failure (AHRF).

Design and setting

Randomized controlled study in a Respiratory Intermediate Care Unit.

Patients

All consecutive patients admitted for AHRF were randomly assigned to receive bilevel NIV either with a cephalic mask (n = 17) or an oronasal mask (n = 17) during the first 48 h.

Measurements

The main outcome criterion was the improvement of arterial pH, 24 h after NIV initiation. Secondary criteria included PaCO2 and physiological parameters.

Results

Compared to values at inclusion, pH, PaCO2, encephalopathy score, respiratory distress score and respiratory frequency improved significantly and similarly with both masks. None of these parameters showed statistically significant differences between the masks at each time point throughout the study period. Mean delivered inspiratory and expiratory pressures were similar in both patient groups. Tolerance of the oronasal mask was improved at 24 h and further. One patient with the cephalic mask suffered from claustrophobia that did not lead to premature study interruption.

Conclusions

In spite of its larger inner volume, the cephalic mask has the same clinical efficacy and requires the same ventilatory settings as the oronasal mask during AHRF.

Keywords

Noninvasive ventilation Facial mask Acute respiratory failure Cephalic mask 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Antoine Cuvelier
    • 1
    • 2
  • Wilfried Pujol
    • 1
  • Stéphanie Pramil
    • 1
  • Luis Carlos Molano
    • 1
  • Catherine Viacroze
    • 1
  • Jean-François Muir
    • 1
  1. 1.Pulmonary and Intensive Care DepartmentRouen University Hospital & UPRES EA 3830 (IFR MP23), Institute for Biomedical Research, University of RouenRouenFrance
  2. 2.Service de Pneumologie et Unité de Soins Intensifs RespiratoiresRouen CedexFrance