Comparison of Oronasal and Nasal Masks in Home Mechanical Ventilation: an Observational Cohort and Bench Study

Overview

Journal Eur Respir J

Specialty Pulmonary Medicine

Date 2024 Oct 14

PMID 39401860

Authors

Emeline Fresnel

Christian Caillard

Marius Lebret

Lea Razakamanantsoa

Adrien Kerfourn

Johan Dupuis

Jean-Francois Muir

Elodie Lhuillier

Kinan El Husseini

Thomas Similowski

Antoine Cuvelier

Maxime Patout

Affiliations

Soon will be listed here.

Abstract

Background: In patients with chronic respiratory failure, home non-invasive ventilation (NIV) is delivered through oronasal or nasal masks. Masks are a cornerstone for NIV success but can be associated with side-effects. However, the type, frequency and consequences of these side-effects are unknown. Here, we aimed to study the prevalence, nature and impact of mask-related adverse events in a cohort of stable patients. We then investigated differences between oronasal and nasal masks both in our cohort and in a bench study.

Methods: This was a prospective observational cohort including patients established on long-term NIV admitted for their elective review. Data regarding mask-related side-effects were assessed using a structured questionnaire. Our bench study was performed using a three-dimensional printed head connected to an artificial lung.

Results: 800 patients were included, of whom 84% had an oronasal mask. Moderate to very severe mask-related side-effects occurred in 47% of patients and severe to very severe side-effects occurred in 18% of patients. Side-effects were associated with poorer daytime arterial partial pressure of carbon dioxide (p=0.005), poorer subjective sleep quality (p=0.003) and poorer quality of life (p<0.001). Mask-related side-effects were more frequently reported with the use of oronasal masks compared to nasal masks (p=0.023). Our bench study showed that nasal masks were more stable than oronasal masks (p<0.001).

Conclusions: Mask-related side-effects are frequent and associated with poorer outcomes. Our data suggest that nasal masks may have a better tolerance profile and should be used as a first-line interface.

Citing Articles

Relevance of telemonitoring algorithms for the management of home noninvasive ventilation.

Bianquis C, El Husseini K, Razakamanantsoa L, Kerfourn A, Fresnel E, Borel J ERJ Open Res. 2025; 11(2).

PMID: 40040887 PMC: 11874130. DOI: 10.1183/23120541.00509-2024.

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