Nasal versus oronasal mask in home mechanical ventilation: the preference of patients as a strategy for choosing the interface.

INTRODUCTION In home mechanical ventilation (HMV), the mask is a key factor for patient comfort and therapeutic adherence. There is no evidence on the best strategy for choosing the mask in HMV. OBJECTIVE To explore patient preference when prescribing the mask for HMV treatment and assess its relationship with effectiveness. METHODS A prospective study with repeated measures in stable patients receiving home nocturnal ventilation. Alternating oronasal mask (ONM) and nasal mask (NM) were tested in day and overnight sessions, with arterial blood gas measured and S(pO(2)) monitored. At the end of each evening session, patients rated interface comfort using a visual analog scale. At 3 months we evaluated adherence and effectiveness of the treatment. RESULTS Twenty-nine subjects (mean ± SD age 65 ± 13 y, 44% male) completed the study. Initial functional values were P(CO(2)) 57.4 ± 5.2 mm Hg and time with S(pO(2)) < 90% (T90) 81.5 ± 9.5%. Both ONM and NM significantly decreased P(CO(2)) and T90. Over a third (38%) of our subjects preferred ONM, while NM was deemed more comfortable in general. At 3 months, effectiveness and adherence showed no differences between those treated with NM or ONM. CONCLUSIONS Patient choice is an effective criterion for selecting the interface in HMV treatment.