Pilot Physiological Evaluation of an Investigational Mask with Expiratory Washout.
The goal of this pilot randomized cross-over study is to compare the effect of a full-face mask with expiratory washout to a conventional full face mask on non-invasive ventilation (NIV) in patients with acute hypercapnic, and acute hypoxemic, respiratory failure. The main questions it aims to answer are: * Does a mask with expiratory washout improve minute ventilation in patients using non-invasive ventilation compared with a conventional single-limb NIV mask * How does a mask with expiratory washout affect respiratory variables compared with a dual-limb NIV mask. Participants already prescribed NIV will undergo 3 arms of the investigation in a randomized order: * Single-limb NIV with investigation mask (with expiratory washout) * Single-limb NIV with conventional mask * Dual-limb NIV with conventional mask
• No indication of intubation upon evaluation by physician in the next 2 hours
• Fits the investigational mask
∙ Specific for hypercapnic patients 1 of the following criteria
• Patients hospitalized with acute respiratory failure (ARF) stabilized and tolerating NIV or;
• Patient admitted to hospital with ARF with one criteria for NIV among the following:
‣ Acute hypercapnic respiratory failure with hypercapnia and acidosis (Partial pressure of arterial carbon dioxide (PaCO2) \> 45 millimeters of mercury (mmHg) and pH \< 7.38) or
⁃ Post-extubation period within 48 hours, in patients with high risk of re-intubation
∙ Specific for hypoxemic patients
∙ 1 of the following criteria
• Hypoxemic respiratory failure without hypercapnia requiring nasal high flow or;
• Hypoxemic respiratory failure without hypercapnia requiring NIV or;
• Conventional oxygen therapy (COT) \> 6 liters per minute (L/min) with peripheral oxygen saturation (SpO2) \< 92%