Cardiothoracic & vascular anaesthesia
Efficacy of Noninvasive Ventilatory Therapies Through Different Interfaces in the Postoperative Care of Cardiac Surgery Patients: A Randomized Controlled Trial
Authors' conclusion
In this trial, full-face interfaces, and the Wolf Mask in particular, were associated with the highest comfort and the lowest inspiratory pressure support, and interface comfort was an independent predictor of mobilization progression.
Study context
- Population
- Patients undergoing elective CABG or valve surgery, high-complexity intensive care unit (ICU) of a tertiary care hospital, July 2023 to May 20266 groups
- Participants
- 172 patients
- Comparison
- 5 noninvasive ventilatory strategies (oronasal mask, full-face mask, Wolf Mask, ELMO helmet CPAP, HFNC) vs conventional physiotherapy without active ventilatory support
- Primary endpoint
- Interface comfort and mobilization progression
Methodological detailsprospective, Three daily 60-minute sessions of assigned modality with standard physiotherapy, ICU admission to discharge
- Prospective
- Three daily 60-minute sessions of assigned modality with standard physiotherapy, ICU admission to discharge
Primary result
As reported in the abstract
G-WOLF
9.41
± 0.68 · 0-10 VAS
- Control: lowest mobilization levels; reaching mobilization level 3 at ICU discharge 18% vs 73%-74% in full-face groups
- 18% v 73%-74%
- Interface comfort an independent positive predictor of mobilization progression (linear mixed-effects modeling)
- P = 0.004
Secondary outcomes
| Outcome | Values |
|---|---|
| Inspiratory pressure support to reach target tidal volume (6 mL/kg ideal body weight) | G-WOLF 5.62 ± 2.08 cmH₂O |
Inspiratory pressure support to reach target tidal volume (6 mL/kg ideal body weight)
- Wolf Mask required the lowest inspiratory pressure support
PPCs
- Wolf Mask: no bibasal atelectasis and lowest overall pulmonary complication rate; control highest complication rate; HFNC no advantage over full-face interfaces
- Exploratory and hypothesis-generating
Arterial oxygenation
- Full-face mask second-best; ELMO helmet poorest oxygenation values
- Exploratory and hypothesis-generating
Original publication
Efficacy of Noninvasive Ventilatory Therapies Through Different Interfaces in the Postoperative Care of Cardiac Surgery Patients: A Randomized Controlled Trial. J Cardiothorac Vasc Anesth. Published 6 September 2026. doi:10.
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