Article Figures & Data
Figures
- Fig. 1.
Mask fit process. The mask fit process begins with 3-dimensional surface images of the subject's face (A). Three-dimensional scans are obtained of noninvasive mask types and sizes. Using the software (3dMD Vultus), the images are rotated, aligned (B), and registered to achieve contact between face and mask (C). Panel D shows a top down view of the mask fitted to the face. Portions of the mask come through the face to achieve fit, indicating that the mask pushes into the face.
- Fig. 2.
Impact of craniofacial anomaly on face mask-related skin compromise. The skin compromise was of the more severe types (eg, stage III pressure ulcer and deep tissue injury [DTI]) among subjects with craniofacial anomalies compared with those without anomalies. However, the group differences did not reach statistical significance because P values were .06 for ϕ, Cramer's V, and contingency coefficient procedures.
- Fig. 3.
Representative images of 5 subjects are shown. Panel A shows erythema on the nose immediately after the mask for overnight NIV was removed in the morning. Non-blanching erythema consistent with a stage I pressure ulcer persisted throughout the day. The subject in panel B has stage I pressure ulcers on the right cheek and forehead. Panel C shows a stage II ulcer on the forehead that developed over 1 night of wear. Panels D and E show stage II and stage III pressure ulcers, respectively, on the nasal bridge.
- Fig. 4.
The distances between mask and left and right cheeks were smaller for nasal versus oronasal and face shield (P < .05). The total face mask had the smallest distance at the bottom (P < .05), due to negative values (away from the face) in some subjects. All 3 differed in the distance from the forehead with nasal having the greatest value, ie, into the face at the forehead (P < .05). Values are shown as mean ± SD (error bars).
- Fig. 5.
A 5-month-old subject had a stage II pressure ulcer on the nose bridge while using the nasal mask. The mean distance from the face to mask was 3.0 ± 4.1 mm, indicating that it was pushing into the face. Compression would be expected on the forehead, with distances of 11.7, 12.2, and 12.0 mm, well above the mean and μ + σ; the nose bridge (3.1 mm); and the lower corner (3.7 mm). The circled/shaded numbers (B) indicate points of highest contact where tissue injury is expected. Panel A shows areas of skin erythema at those points.
- Fig. 6.
A 13-month-old subject had a deep tissue injury on the nose bridge when a nasal mask was used as a full face mask. The facial scan with the mask in place is shown from the front (A) and from behind (B) (ie, as viewed from inside the 3-dimensional scan). The view from behind indicates that the mask is coming through the face to achieve placement. The mean fit distance was 10.6 ± 3.8 mm. C: Point data suggest compression near the bottom on both cheeks (distances 16.0, 16.3, 16.6, and 17.8 mm). The 9.2-mm distance may have been sufficient to cause a deep tissue injury.
- Fig. 7.
An 18-y-old subject had a deep tissue injury on the bridge and a stage II pressure ulcer on the chin when using the oronasal mask. The mean distance was −1.9 mm, due to the forehead piece being away from the face, with a high SD (C). Distances were 7.9, 8.0, and 8.3 mm for the bridge and left cheek points, respectively, constituting the greatest distances into the face. The distances were 4.4 and 4.1 mm along the bottom (chin).
