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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2015 May;81(5):526-32
Non-invasive ventilation: evaluation of CO2 washout by intentional leaking in three recent oronasal masks. A pilot study
Medrinal C. 1, Prieur G. 1, Contal O. 2, Villiot-Danger E. 3, Doyle C. 4, Reychler G. 5, Quieffin J. 1 ✉
1 Groupe Hospitalier du Havre, Service de Pneumologie, Montivilliers, France;
2 University of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland;
3 Centre des Maladies Respiratoires Les Acacias, Briançon, France;
4 Institut de Formation en Masso-Kinésithérapie, Rouen, France;
5 Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ENT & Dermatologie, Université Catholique de Louvain, Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgique
BACKGROUND: Many types of interfaces with intentional leaks exist for Non Invasive Ventilation. The purpose of intentional leaks is to remove CO2 from the interface, however the calibration does not allow a sufficiently large flow and rebreathing of CO2 can occur. The aim of this study was to compare the CO2 rinsing capacities of three new generation oronasal masks with intentional leaks (A: Quattro®, [Resmed]; B: Amara® [Respironics]; C: Forma® [Fisher&Paykel]) in healthy subjects.
METHODS: Seventeen healthy volunteers were included in this prospective cross-sectional, randomized, double-blinded trial. Each subject underwent ventilation with a home ventilator (IPAP: 14 cmH2O; EPAP: 4 cmH2O) with each mask consecutively. Transcutaneous capnography (PtcCO2) recordings were carried out throughout the trial and ventilator data (tidal volume, respiratory rate, minute ventilation and unintentional leaks) were also analyzed. Mask comfort was assessed using a visual analog scale (0 to 10).
RESULTS: The results showed no differences in PtcCO2 between masks (P=0.82). There were no significant differences in respiratory parameters (tidal volume, P=0.79; respiratory rate, P=0.65; minute ventilation, P=0.12) between masks. The rate of unintentional leaks were significantly lower for Mask A (P=0.016). Subjects rated Mask A and Mask C as more comfortable than Mask B (P=0.041).
CONCLUSION: There was no effect of mask on PtcCO2 in healthy subjects. The mask with the highest comfort rating had not the lowest rate of unintentional leaks.