Rescue Therapy by Switching to Total Face Mask After Failure of Face Mask-Delivered Noninvasive Ventilation in Do-Not-Intubate Patients in Acute Respiratory Failure*

Lemyze, Malcolm; Mallat, Jihad; Nigeon, Olivier; Barrailler, Stéphanie; Pepy, Florent; Gasan, Gaëlle; Vangrunderbeeck, Nicolas; Grosset, Philippe; Tronchon, Laurent; Thévenin, Didier

doi:10.1097/ccm.0b013e31826ab4af

Cited by 62 publications

(76 citation statements)

References 35 publications

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“…[10][11][12][13] In a particular group of subjects with a do-notintubate order and with a previous NIV trial failure, a change in mask increased the success and hospital discharge rates. 14 Open-circuit mouthpiece ventilation is a type of NIV delivered via a mouthpiece as interface. It was proposed many years ago in the home-care setting to treat chronic respiratory failure in neuromuscular diseases, especially in North America.…”

Section: See the Original Study On Page 1825mentioning

confidence: 99%

Mouthpiece Ventilation: Just a Home-Care Support?

Carlucci

Gregoretti

2014

Respir Care

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Section: See the Original Study On Page 1825mentioning

confidence: 99%

Mouthpiece Ventilation: Just a Home-Care Support?

Carlucci

Gregoretti

2014

Respir Care

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“…DNI patients with ARF often require long periods of continuous NIV, a situation that commonly leads to painful facial skin breakdown and discomfort despite careful precautions. We have recently shown that switching to a total face mask might be an interesting option in DNI patients, when face mask-delivered NIV fails to reverse hypercapnic ARF or when NIV cannot be carried on because of intolerance of the interface [2]. Another practical hurdle to overcome at the bedside when NIV is considered in DNI patients is that hypercapnic encephalopathy is commonly associated with agitation and delirium.…”

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confidence: 99%

NIV should be delivered in do-not-intubate patients in acute respiratory failure, but how?

et al. 2013

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“…Patients switched to use of the full-face mask had significantly fewer pressure ulcers develop without a protective dressing. 7 In our ICUs, we observed stage III and IV pressure ulcers as well as deep tissue injury with a nasal-oral mask. The objective of this study was to examine the incidence, location, and stage of pressure ulcers and patients' comfort with a nasal-oral mask (Performatrak, Respironics, Philips Healthcare) compared with a full-face mask (Performax, Respironics, Philips Healthcare).…”

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confidence: 99%

“…[6][7][8] No research related to interventions to reduce the incidence or severity of pressure ulcers associated with noninvasive ventilation was found. However, several non-research-based recommendations were found in the literature.…”

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confidence: 99%

“…[3][4][5] Identification of device-related pressure ulcers, such as those associated with noninvasive ventilation masks, is becoming more common. [6][7][8] No research related to interventions to reduce the incidence or severity of pressure ulcers associated with noninvasive ventilation was found. However, several non-research-based recommendations were found in the literature.…”

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confidence: 99%

See 1 more Smart Citation

Pressure Ulcer Incidence in Patients Wearing Nasal-Oral Versus Full-Face Noninvasive Ventilation Masks

Schallom¹,

Cracchiolo²,

Falker³

et al. 2015

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Explain the importance of checking for pressure ulcers. 2. Identify areas of high risk for skin breakdown. 3. Enumerate advantages of wearing a full-face mask.To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue. " No CE test fee for AACN members.Background Device-related pressure ulcers from noninvasive ventilation masks alter skin integrity and cause patients discomfort. Objective To examine the incidence, location, and stage of pressure ulcers and patients' comfort with a nasal-oral mask compared with a full-face mask. Methods A before-after study of a convenience sample of patients with noninvasive ventilation orders in 5 intensive care units was conducted. Two groups of 100 patients each received either the nasal-oral mask or the full-face mask. Skin was assessed before the mask was applied and every 12 hours after that or upon mask removal. Comfort levels were assessed every 12 hours on a Likert scale of 1 to 5 (1, most comfortable). Results A pressure ulcer developed in 20% of patients in the nasal-oral mask group and 2% of patients in the full-face mask group (P < .001). Comfort scores were significantly lower (more comfortable) with the full-face mask (mean [SD], 1.9 [1.1]) than with the nasal-oral mask (mean [SD], 2.7 [1.2], P < .001). Neither mean hours worn nor percentage adherence differed significantly: 28.9 (SD, 27.2) hours and 92% for full-face mask and 25 (SD, 20.7) and 92% for nasal-oral mask. No patients who had a pressure ulcer develop with the nasal-oral mask had a pressure ulcer develop with the full-face mask. Conclusion The full-face mask resulted in significantly fewer pressure ulcers and was more comfortable for patients. The full-face mask is a reasonable alternative to traditional nasal-oral masks for patients receiving noninvasive ventilation. (American Journal of Critical Care. 2015;24:349-357) 1 The goal of noninvasive ventilation is to relieve symptoms associated with hypoventilation, exacerbation of chronic obstructive pulmonary disease, or impending respiratory failure; enhance gas exchange; maximize patients' comfort; and avoid intubation and invasive ventilation.1,2 Use of noninvasive ventilation is associated with device-related development of pressure ulcers under the mask. Published rates for the incidence of facial pressure ulcers associated with noninvasive ventilation masks range from 10% to 31%.3-5 Identification of device-related pressure ulcers, such as those associated with noninvasive ventilation masks, is becoming more common. [6][7][8] No research related to interventions to reduce the incidence or severity of pressure ulcers associated with noninvasive ventilation was found. However, several non-research-based recommendations were found in the literature. The Minnesota Hospital Association and recently the National Pressure Ulcer Advisory Panel (NPUAP) recommended consideration o...

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Rescue Therapy by Switching to Total Face Mask After Failure of Face Mask-Delivered Noninvasive Ventilation in Do-Not-Intubate Patients in Acute Respiratory Failure*

Cited by 62 publications

References 35 publications

Mouthpiece Ventilation: Just a Home-Care Support?

Mouthpiece Ventilation: Just a Home-Care Support?

NIV should be delivered in do-not-intubate patients in acute respiratory failure, but how?

Pressure Ulcer Incidence in Patients Wearing Nasal-Oral Versus Full-Face Noninvasive Ventilation Masks

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