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Respiratory Care |

Taste Test: Providing Patient Choice of Noninvasive Ventilation Modalities

Herbert Patrick, MD; Mao Pezzella, RRT; Debbie Rose, BSN
Author and Funding Information

Mercy Suburban Hospital-Critical Care, East Norriton, PA


Chest. 2013;144(4_MeetingAbstracts):882A. doi:10.1378/chest.1704988
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Abstract

SESSION TITLE: Respiratory Support Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Hospitalized patients receive noninvasive ventilation (NIV) to reduce work of breathing, increase ventilation, improve oxygenation and hopefully avoid intubation. However, many patients find they are uncomfortable with NIV nasal or oronasal masks and abort physician prescribed treatments. We hypothesized that if patients could "taste test" a selection of NIV facial interfaces and generators, they could identify the most comfortable set up. Use of this selected set up should improve NIV compliance.

METHODS: Three NIV modalities were selected for the "Taste Test": Respironics Vision (BiPAP®), Fisher Paykel OptiFlow™ nasal high flow (NHF), and Breathe BT-V2S Noninvasive Open Ventilation (NIOV™). In-patients with acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) were randomly selected. Patients unable to understand the purpose of the trials, i.e., altered mental status patients, and those unable to express their opinions, i.e., aphasia patients, were excluded. A physician ordered the settings for each NIV system and a Respiratory Care Practitioner applied each NIV system to the patient based on a randomized sequence. After the patients had a "taste test" of all three NIV systems, the RCP asked the patient to rank each on a scale from 1, uncomfortable, to 10, comfortable. The NIV system with the highest rank was then applied to the patient.

RESULTS: The most comfortable NIV system was NIOV™ due to the nasal cannula interface, followed by NHF, followed by BiPAP®.

CONCLUSIONS: Questioning patient preference among three NIV systems permits each patient to use the system they determine to be most comfortable. The hypothesis was supported.

CLINICAL IMPLICATIONS: New NIV systems are presently available. Patient preference due to comfort and efficacy may be a significant factor for compliance with the prescribed therapy. An NIV system questionnaire could be developed to provide an objective measure of patient preference.

DISCLOSURE: The following authors have nothing to disclose: Herbert Patrick, Mao Pezzella, Debbie Rose

No Product/Research Disclosure Information


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