Helmet interface increases lung volumes at equivalent ventilator pressures compared to the face mask interface during non-invasive ventilation

High Flow Nasal Cannula Oxygenation The current pandemic of COVID-19 caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tested the healthcare infrastructure throughout the globe at all possible levels. Early reports suggest about 20% of patients infected with SARS-CoV-2 require hospitalization and 5-8% require admission to intensive care unit (ICU) due to severe disease.Supplementation of oxygen provided by various conventional oxygen therapy (COT) devices (like nasal prongs, face mask, venture mask or non-rebreather mask) may not be sufficient in cases of worsening respiratory failure. One form of escalating respiratory support in such patients is a high flow nasal oxygenation device. High flow nasal cannula oxygenation (HFNC) is a form of non invasive respiratory support. It acts as a bridge between low flow devices and non invasive ventilation and may reduce the need for intubation.

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Intermittent abdominal pressure ventilation: feasibility and efficacy in neuromuscular disease. A case report

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2021.1828 ◽

2021 ◽

Author(s):

Cristina Puricelli ◽

Eleonora Volpato ◽

Salvatore Sciurello ◽

Antonello Nicolini ◽

Paolo Banfi

Keyword(s):

Neuromuscular Disease ◽

Standard Treatment ◽

Face Mask ◽

Abdominal Pressure ◽

Nasal Mask ◽

Invasive Ventilation ◽

Non Invasive ◽

Nocturnal Hypoventilation ◽

Non Invasive Ventilation ◽

Ventilation Support

he standard treatment for patients with neuromuscular respiratory failure is non-invasive ventilation (NIV) as non-invasive ventilation support-setting (NVS). NVS is administered through a nasal or face mask and/or mouthpiece with the potential to cause nasal ulcers, discomfort, and/or aesthetic issues, resulting in poor compliance. We reported the observation of a 45-year-old woman with limb-girdle muscular dystrophy (LGMD), secondary to Dysferlin deficiency, who was on NVS since 2017 for nocturnal hypoventilation. In 2018, despite nocturnal ventilation, due to weight gain and daytime hypoventilation, a nasal mask was introduced. We initiated daytime intermittent abdominal pressure ventilation (IAPV) to mitigate cosmetic problems, improving in pO2 and decreasing in pCO2 versus baseline (52>84 mmHg, 46>33 mmHg respectively) at 6 (85 mmHg, 42 mmHg) and 18 months (93 mmHg, 38 mmHg), respectively. IAPV was effective, safe, and well-tolerated in our patients who did not tolerate standard daytime NVS with the known interface.

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Evaluation of patient skin breakdown and comfort with a new face mask for non-invasive ventilation: a multi-center study

Intensive Care Medicine ◽

10.1007/s00134-002-1208-7 ◽

2002 ◽

Vol 28 (3) ◽

pp. 278-284 ◽

Cited By ~ 81

Author(s):

Cesare Gregoretti ◽

Marco Confalonieri ◽

Paolo Navalesi ◽

Vincenzo Squadrone ◽

Pamela Frigerio ◽

...

Keyword(s):

Face Mask ◽

Invasive Ventilation ◽

Non Invasive ◽

Skin Breakdown ◽

Non Invasive Ventilation ◽

Multi Center Study ◽

Center Study

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Randomised trial of nasal mask versus full-face mask for the application of non-invasive ventilation in patients admitted to Queen's Medical Centre with an acute exacerbation of chronic obstructive airways disease and hypercapnic respiratory failure

http://isrctn.org/> ◽

10.1186/isrctn63026442 ◽

2012 ◽

Author(s):

WJ Kinnear

Keyword(s):

Randomised Trial ◽

Face Mask ◽

Chronic Obstructive ◽

Nasal Mask ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Obstructive Airways Disease ◽

Full Face ◽

Chronic Obstructive Airways Disease

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Non-invasive ventilation by helmet more effective than face mask in acute respiratory distress syndrome

The Lancet Respiratory Medicine ◽

10.1016/s2213-2600(16)30183-7 ◽

2016 ◽

Vol 4 (8) ◽

pp. 610

Author(s):

Hilary Marshall

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Face Mask ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation

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Comparative bench study evaluation of a modified snorkeling mask used during COVID-19 pandemia and standard interfaces for Non-Invasive Ventilation

10.21203/rs.3.rs-116165/v1 ◽

2020 ◽

Author(s):

Giuliano Ferrone ◽

Giorgia Spinazzola ◽

Roberta Costa ◽

Edoardo Piervincezi ◽

Antonio Gullì ◽

...

Keyword(s):

Pressure Support ◽

Peak Inspiratory Pressure ◽

Face Mask ◽

Invasive Ventilation ◽

Emergency Situations ◽

Non Invasive ◽

Bench Study ◽

Non Invasive Ventilation ◽

And Performance ◽

Full Face

Abstract Background COVID-19 infection has put enormous pressure on the healthcare systems worldwide and especially on Intensive Care Units (ICUs). In this particular situation, a modified snorkeling mask into a mask for non-invasive continuous positive airway pressure (nCPAP) and non-invasive ventilation (NIV), with the help of 3D printers, has been proposed for clinical use. We designed a bench study to compare a Helmet (H), a Full face mask (RFF) and a modified full face snorkeling mask (MFF) for delivering nCPAP and NIV in pressure support mode (PSV). Methods A mannequin was connected to an active lung simulator. The inspiratory and expiratory variations in airways pressure observed with a high simulated effort (Pmus), were determined relative to the preset CPAP level. NIV was applied in PSV at two simulated respiratory rates and two cycling-off flow thresholds. During the bench study we measured the variables defining patient-ventilator interaction and performance. Results During nCPAP, the MFF presented significantly lower values of ΔPawi and ∆Pawe compared to the other interfaces tested (H and RFF). During NIV, the MFF demonstrated a better patient-ventilator interaction compared to RFF, as shown by significantly shorter Timepress and Delaytrexp (p < 0.01), but no significant differences were found in terms of Delaytrinsp and Timesync between the interfaces tested. At RR 20sim, the MFF presented the shorter ΔPtrigger (p < 0.01), moreover during all the conditions tested the MFF showed the longer PTP 200, 300 and 500 compared to RFF (p < 0.01). A major limitation of MFF is that during NIV with this interface it is possible to reach at maximum 18 cmH2O of peak inspiratory pressure. Over this pressure value, the presence of air leaks determined important asynchrony phenomena. For this reason, our test was limited to one pressure support and PEEP set (PS 10 cmH2O and PEEP 8 cmH2O). Conclusions The modified full face snorkeling mask can be used as an acceptable alternative to other interfaces for both nCPAP and NIV in emergency situations.

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Outcome of Non-Invasive Ventilation in Patients of Acute Respiratory Failure.

Nepal Medical Journal ◽

10.37080/nmj.119 ◽

2021 ◽

Vol 4 (1) ◽

pp. 21-26

Author(s):

Anusmriti Pal ◽

Manoj Kumar Yadav ◽

Chiranjeevi Pant

Keyword(s):

Intensive Care Unit ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Face Mask ◽

Invasive Ventilation ◽

Failure Group ◽

Non Invasive ◽

Arterial Blood ◽

Copd Patients ◽

Non Invasive Ventilation

Introduction: Non-invasive ventilation (NIV) is a method of ventilator support or delivery of positive pressure into the lungs usually through a face mask, mostly initiated before severe acidosis occurs. NIV failure requiring invasive mechanical ventilation in decompensated chronic obstructive pulmonary disease (COPD) patients is low, but, in critical patients, it is as high as 60%. Acute respiratory failure (ARF) is the common reason for admission to the intensive care unit. This study assesses the outcome of NIV among patients with acute respiratory failure, the duration of use, stay in ICU, and failure rate of NIV. Such type of study result is scarce in our country. Methods: Arterial blood gases were assessed prior, after, and at discontinuation of NIV. NIV was delivered by ventilator via face mask. All patients above age 15 years who presented to the hospital, diagnosed to have ARF by ABG were included and admitted to Medical Intensive Care Unit (MICU). . Appropriate statistical tests (Chi-square) were performed and the statistical significance of the results was assessed. Results: 35 patients with the median age of 73 years (range: 39- 89 years), of 60.0 % females among which 74.3 % were current smokers. Arterial blood pH prior to admission ranged from 7.11-7.39 and 7.06-7.41 among NIV success and failure, respectively. Similarly, PCo2 ranged from 54.0-127.5 and 29.5-105.9 among them, respectively. Two hours after ventilation pH ranged from 7.12-7.43 and 7.05-7.30 respectively in the success and failure group. The most common disease condition requiring NIV was 77.1% COPD. Out of NIV failure group (n=19) ,57.8 % were intubated and 42.1% patients left the intervention. Conclusions: Usage of NIV among ARF patients was associated with lower intubation and ICU mortality rate. COPD patients showed the most benefit with NIV, whereas patients suffering from interstitial lung disease, lung cancer had less benefit.

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Faculty Opinions recommendation of Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interaction during non-invasive ventilation delivered by face mask.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717961067.793463874 ◽

2012 ◽

Author(s):

Jennifer Beck

Keyword(s):

Face Mask ◽

Neurally Adjusted Ventilatory Assist ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Ventilatory Assist

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The DELUX study: development of lung volumes during extubation of preterm infants

Pediatric Research ◽

10.1038/s41390-021-01699-w ◽

2021 ◽

Author(s):

Leonie Plastina ◽

Vincent D. Gaertner ◽

Andreas D. Waldmann ◽

Janine Thomann ◽

Dirk Bassler ◽

...

Keyword(s):

Preterm Infants ◽

Functional Residual Capacity ◽

Adhesive Tape ◽

List Type ◽

Invasive Ventilation ◽

Lung Volumes ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Residual Capacity ◽

The Impact

Abstract Objective To measure changes in end-expiratory lung impedance (EELI) as a marker of functional residual capacity (FRC) during the entire extubation procedure of very preterm infants. Methods Prospective observational study in preterm infants born at 26–32 weeks gestation being extubated to non-invasive respiratory support. Changes in EELI and cardiorespiratory parameters (heart rate, oxygen saturation) were recorded at pre-specified events during the extubation procedure compared to baseline (before first handling of the infant). Results Overall, 2912 breaths were analysed in 12 infants. There was a global change in EELI during the extubation procedure (p = 0.029). EELI was lowest at the time of extubation [median (IQR) difference to baseline: −0.30 AU/kg (−0.46; −0.14), corresponding to an FRC loss of 10.2 ml/kg (4.8; 15.9), padj = 0.004]. The biggest EELI loss occurred during adhesive tape removal [median change (IQR): −0.18 AU/kg (−0.22; −0.07), padj = 0.004]. EELI changes were highly correlated with changes in the SpO2/FiO2 ratio (r = 0.48, p < 0.001). Forty per cent of FRC was re-recruited at the tenth breath after the initiation of non-invasive ventilation (p < 0.001). Conclusions The extubation procedure is associated with significant changes in FRC. This study provides novel information for determining the optimal way of extubating a preterm infant. Impact This study is the first to examine the development of lung volumes during the entire extubation procedure including the impact of associated events. The extubation procedure significantly affects functional residual capacity with a loss of approximately 10 ml/kg at the time of extubation. Removal of adhesive tape is the major contributing factor to FRC loss during the extubation procedure. Functional residual capacity is regained within the first breaths after initiation of non-invasive ventilation and is further increased after turning the infant into the prone position.

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