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Clinical Investigations: Mask VentilationEfficacy of a New Full Face Mask for Noninvasive Positive Pressure Ventilation
Section snippets
Patient Selection
All patients were admitted to the Ventilator Rehabilitation Unit at Temple University Hospital, Philadelphia, for evaluation and treatment of chronic respiratory failure. This noninvasive respiratory care unit evaluates patients for noninvasive mechanical ventilation, instructs patients in the use of respiratory equipment, provides whole body and respiratory muscle reconditioning, and coordinates continuing outpatient follow-up.
Prior to admission all patients were maximally treated with
Results
Patient characteristics are shown in Table 2. Three patients had severe obstructive lung disease, and six patients had severe restrictive disorders. The patients’ ages ranged from 44 to 81 years. Three of the nine patients suffered from acute superimposed on chronic respiratory failure that had necessitated recent (within 6 months of the study) endotracheal intubation and mechanical ventilation. The remaining patients had a more gradual, progressive worsening of their respiratory status. Five
Discussion
There was a significant improvement in gas exchange short term during NPPV with all three masks; however, the reduction in PaCO2 was greatest when NPPV was delivered with the TFM. This is attributed to the observation that the increases in expired tidal volume and minute ventilation were greatest with the use of the total face mask. In addition, dyspnea, discomfort with the face mask, and level of mask or mouth leaks were least during NPPV with the TFM compared with the N or NO masks. Moreover,
ACKNOWLEDGEMENTS
We would like to acknowledge the donation of the Total masks used during this study by Respironics, and the secretarial assistance of Darlene Macon.
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Cited by (105)
The influence of changing interfaces on aerosol delivery within high flow oxygen setting in adults: An in-vitro study: Impact of interface changing on aerosol in high flow oxygen setting
2020, Journal of Drug Delivery Science and TechnologyCitation Excerpt :On the other hand, the dead space volume of the oronasal mask is greater than that of a nasal cannula or that of the mouthpiece which may suggest some aerosol saving while exhaling than nasal cannula of the lowest dead volume. The length of the cannulae had the main contribution over the interface's dead space volume encouraging aerosol condensation [8,32]. The previous explanation is only applicable at low gas flows but at high flows, neither the dead space nor the diameter exerts an obvious effect on aerosol delivery as the largest portion of aerosol impacted in the heater-humidifier itself and within the circuit before reaching the interface [22].
Noninvasive Options
2018, Critical Care ClinicsCitation Excerpt :NIV interfaces behave differently in respect to CO2 exchange. The face mask constitutes an additional mechanical dead space, and its effect on CO2 rebreathing is proportional to its internal volume.12 Because this volume is small compared with a patient’s tidal volume, the amount of CO2 that is rebreathed is also small.
Comparison of three continuous positive airway pressure (CPAP) interfaces in healthy Beagle dogs during medetomidine–propofol constant rate infusions
2018, Veterinary Anaesthesia and AnalgesiaCitation Excerpt :However, a perfect seal also introduces a higher risk for rebreathing because a lower flow from the CPAP machine can maintain the pressure but the flow may be too low to wash out expired CO2 from the relatively large equipment dead space. This could explain why a higher PaCO2 (0.53 kPa, 4 mmHg) was observed with FM during CPAP-delivery (Criner et al. 1994; Taccone et al. 2004) as almost no leak was observed with this treatment. Unfortunately, PICO2 was not measured during CPAP-delivery.
Interfaces for noninvasive ventilation in the acute setting in children
2017, Paediatric Respiratory ReviewsCitation Excerpt :Because mask-fit pressure is spread over a larger surface beyond the nose area, total face masks may be more comfortable than oronasal masks [28] (Table 1). In adults, the total face mask has shown to be as efficient as an oronasal mask in terms of breathing pattern, gas exchange and outcome [28–30]. However, a total face mask has a larger internal volume and therefore a larger anatomical dead space which may interfere with the efficacy of NIV [31].
Noninvasive Ventilation
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth Edition