Noninvasive Ventilation Facemasks Favoring Carbon Dioxide Washout

Physiological Effects of Novel Noninvasive Ventilation Facemasks Favoring Carbon Dioxide Washout in Patients With Hypercapnic Respiratory Failure

The objective of this randomized cross-over trial is to assess the physiological effects of three different facemasks for noninvasive ventilation (Nivairo, Visairo, Optiniv) in patients with acute hypercapnic respiratory failure

Inclusion Criteria:

Acute respiratory failure with

• PaCO2 ≥ 45 mmHg;
• Arterial pH < 7.35;
• Signed written informed consent

Exclusion Criteria:

• Respiratory rate < 12 bpm;
• Immediate need for intubation;
• Haemodynamic instability (Systolic blood pressure <90 mmHg or mean arterial pressure <65 mmHg) and/or lactic acidosis (lactate >5 mmol/L) and/or clinically diagnosed shock;
• Metabolic Acidosis;
• Recent head surgery or anatomy that prevent the application of facemasks;
• Any contraindications to oesophageal balloon insertion and/or electrical impedance tomography (EIT) belt placement.
• Any contraindications to facemask noninvasive ventilation.