Comparison of “ADAM” and “Respironics” mask-valve system s during non-invasive ventilation in patients with stable hypercapnie respiratory faillure

Abstract

The problem of “ rebreathing” hindering effective removal of carbon dyoxide appears during non-invasive ventilation in patients with chronic hypercapnic respiratory faillure. The aim of our investigation was to com pare two types of m ask-valve system s — “Respironics nasal mask” with the “Whisper-Swivel” valve and “ADAM circuit” internasal mask. Parameters of respiratory pattern, compliance and removal of carbon dyoxide were examined. 12 patients with stable hypercapnic chronic respiratory failure underwent non-invasive ventilation courses using two types of mask/valve system s at various regimens IPAP/EPAP with evaluation of arterial blood gases, tidal volume, “ rebreathing” volume and carbon dyoxide volume into the circuit behind the valve. Also side effects and comfort for patients were evaluated. It was shown that in spite of significant decrease in PaC0₂ during the non-invasive ventilation (p=0.002 for RNM mask and p<0.001 for ADAM mask) usage of ADAM mask provided stastistically significant lower level of “ rebreathing” (p<0.001) and of absolute amount of carbon dyoxide (in millilitres) into the circuit behind the valve (p=0.004). Compliance was better with ADAM m ask which was estimated by the most patients as more comfortable mask. Thus, usage of the ADAM m ask can improve the removal CO₂ and ensure better co-operation between patient and doctor during non-invasive ventilation in patients with stable hypercapnic chronic respiratory failure.