2011 OPEN FORUM Abstracts
PATIENTS' OPINIONS ABOUT SYMPTOMS WITH AND WITHOUT HUMIDIFICATION DURING NONINVASIVE POSITIVE PRESSURE VENTILATION.
Tim Op't Holt, Ali Alqahtani; Cardiorespiratory Care, Univ of South Alabama, Mobile, AL
Background: Noninvasive positive pressure ventilation (NPPV) delivers air at a high flow, which is associated with airway mucosal drying and impaired upper airway function. Humidification and warming of the inspired gases may be required to prevent undesirable effects of cool, dry air on the upper airway mucosa during NPPV. In this study, patients receiving NPPV were asked to quantify symptoms associated with NPPV. We hypothesized that there would be a significant difference in patients' opinions about breathing dry versus humidified air during NPPV. Methods: This study used an unpaired two-group design, using a convenience sample from two hospitals. Patients who were receiving NPPV with or without heated humidification for acute hypercapnic respiratory failure were asked about symptoms such as dry nose/mouth, runny nose, watery eyes, nasal congestion, etc. using a previously described 12 item questionnaire, within 48 hours of the start of ventilation. Patients were asked to reply, "not at all," "somewhat," or "a lot," about their symptoms. All patients were ventilated using the BiPAP Vision ventilator. We followed-up to determine the eventual outcome of NPPV: intubation versus liberation from NPPV. Data analysis from the questionnaire combined the answers somewhat and a lot and compared the result to not at all, using a two-tailed Fisher's Exact test. P was set at .05. Results: Ten patients without humidification and four patients with humidification were included in the study, all of whom were using an oral/nasal mask. There were no differences in the response to the questionnaire between groups with the exception of more patients in the non-humidified group expressing they had dry mouth (p=.005). All patients were successfully liberated from NPPV. None required intubation. Conclusions: In this cohort, absence of humidification was associated with only dry mouth. None of the patients required intubation subsequent to NPPV.
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