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Vol. 42. Issue 4.
Pages 189-193 (April 2006)
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Vol. 42. Issue 4.
Pages 189-193 (April 2006)
Techniques and Procedures
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Comparison of Carbon Dioxide Rebreathing During Application of Continuous Positive Airway Pressure With 3 Types of Nasal Mask
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O. Mediano
Corresponding author
olgamediano@hotmail.com

Correspondence: Dra. O. Mediano. Ginzo de Limia, 40, 3.° 3.a. 28029 Madrid. España
, F. García-Río, C. Villasante
Servicio de Neumología, Hospital Universitario La Paz, Madrid, Spain
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A comparison is made between the end-tidal fractional concentration of carbon dioxide (FETCO2) obtained during application of varying levels of continuous positive airway pressure (CPAP) with a prototype mask (from Carburos Metálicos) and FETCO2 obtained with 2 commonly used nasal masks (Profile Lite and ComfortClassic from Respironics). The nasal FETCO2 was measured on 3 consecutive days in 11 healthy volunteers, 12 patients with severe obstructive sleep apnea-hypopnea syndrome, and 12 hypercapnic patients. A different mask was randomly assigned on each day and the FETCO2 was measured after 3 minutes of CPAP at 4, 5, 6, 8, 10, 15, and 20 cm H2O. Although in all cases a progressive reduction in FETCO2 was observed with increasing CPAP, the effect was greatest with the prototype mask at all pressures. In the 3 different study groups the pressures obtained with the prototype mask were similar to those generated by the CPAP machine. In conclusion, the lower concentration of nasal CO2 obtained using the prototype mask suggests that it causes less rebreathing.

Key words:
Nasal mask
Continuous positive airway pressure
Sleep apnea
Mechanical ventilation
Rebreathing
CO2

Se describe la fracción end-tidal de anhídrido carbónico (FETCO2) originada con una mascarilla prototipo (Carburos Metálicos) durante la aplicación de diferentes niveles de presión positiva continua en la vía aérea (CPAP) y se compara con la desarrollada por 2 mascarillas nasales de uso habitual (Profile Lite y ComfortClassic, Respironics). En 11 voluntarios sanos, 12 pacientes con síndrome de apneas-hipopneas obstructivas durante el sueño de carácter grave y 12 enfermos hipercápnicos, se midió, de forma aleatoria en 3 días sucesivos, la FETCO2 nasal después de 3 min de CPAP a 4, 5, 6, 8, 10, 15 y 20 cmH2O con cada una de las mascarillas. Aunque en todos los casos se logró una reducción progresiva de la FETCO2 al incrementar la presión, ésta fue mayor con la mascarilla prototipo, para cualquier nivel de presión. En los 3 grupos del estudio las presiones alcanzadas en la mascarilla prototipo fueron similares a las generadas por la máquina de CPAP. En conclusión, la menor concentración de anhídrido carbónico nasal durante la aplicación de la mascarilla prototipo induce a pensar que origina una menor reinhalación.

Palabras clave:
Mascarilla nasal
CPAP
Apneas del sueño
Ventilación mecánica
Reinhalación
CO2
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This study was partially funded by Carburos Metálicos.

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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