[Use of a mask as an alternative to endotracheal intubation in acute respiratory failure].

Acute respiratory failure that is unresponsive to medical treatment requires ventilatory support. Non-invasive treatment with a nose or face mask is an alternative to endotracheal intubation in awake and cooperative patients. In patients with acute cardiogenic pulmonary oedema the application of continuous positive airway pressure (CPAP) increases cardiac output. CPAP-treatment is also effective in acute hypercapnic respiratory failure and oxygenation difficulties, but in these conditions pressure or volume-cycled positive pressure ventilation with a mask as an interface often has more to offer. The method reduces the need for endotracheal intubation and hence the time spent by the patient in the intensive care unit, but the need for personnel resources is equal. Possible clinical problems are skin erosions on the bridge of the nose due to pressure from the mask, and systemic hypotension.