How to avoid interface problems in acute noninvasive ventilation

Brill, Anne-Kathrin

doi:10.1183/20734735.003414

Cited by 67 publications

(103 citation statements)

References 39 publications

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“…As the interface is critical to patient comfort, NIV effectiveness, and the compliance of the patient with NIV therapy, a number of factors should be considered when selecting the interface to guarantee both patient comfort and an appropriate interface fit 23Table 3 summarizes the features of an ideal NIV interface 24…”

Section: Interface Selectionmentioning

confidence: 99%

“…Many other patient conditions can facilitate ulcer development ( Table 4 ) 24. However, according to the literature, the primary cause of pressure ulcers is a lack of awareness and understanding of how to check the skin, how often to disconnect the NIV device, and how to ensure an appropriate mask seal without progressively increasing the strap tension 32.…”

Section: Risk Factors For Facial Pressure Ulcers Development and Theimentioning

confidence: 99%

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Evidence based synthesis for prevention of noninvasive ventilation related facial pressure ulcers

Alqahtani¹,

AlAhmari²

2018

SMJ

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The last 2 decades have seen a growing trend towards the use of noninvasive ventilation (NIV) therapy in the management of many conditions that cause acute respiratory failure. However, there is a serious side effect that results in using these devices; the development of facial skin pressure damage, specifically pressure ulcers. This skin damage has a considerable effect on patients’ quality of life, treatment adherence and patients’ comfort in addition to the therapy challenges of wound care. The aim of this clinical review is to discuss the different characteristics of NIV interfaces and to provide evidence based recommendations to facilitate the selection and application of such interfaces to reduce NIV interfaces related pressure ulcers.

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Section: Interface Selectionmentioning

confidence: 99%

Section: Risk Factors For Facial Pressure Ulcers Development and Theimentioning

confidence: 99%

Evidence based synthesis for prevention of noninvasive ventilation related facial pressure ulcers

Alqahtani¹,

AlAhmari²

2018

SMJ

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“…Efforts are made to prevent or reduce damage using pressure relief dressings which can improve the situation but doesn't address the underlying problem [29,35]. Another approach is to alternate the type of interface chosen to vary the area of skin insulted but this is also a short-term solution.…”

Section: Adverse Effects Of Interfacesmentioning

confidence: 99%

A Review of the Benefits, Challenges and the Future for Interfaces for Long Term Non-Invasive Ventilation in Children

Nicki¹,

Willox²,

Heather³

2018

Int J Respir Pulm Med

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Long Term Non-Invasive Ventilation (NIV) is increasingly common and is benefitting children with a wider range of conditions. It improves quality of life and life expectancy and reduces hospital admissions and length of stay. Children are at risk however of adverse effects caused by NIV interfaces such as skin injury, facial flattening and eye problems. The correct size interface, that is properly fitted, can decrease the risk of device related injury but it remains difficult to fit interfaces to children with particularly small, syndromic or asymmetrical face shapes. Specialist centres are producing semi-custom and fully custom-made interfaces in an attempt to improve fit and decrease device related injury. Recent advances in modern technology such as facial scanning and 3D printing are making custom made interfaces a more viable solution, but it is not yet known whether these approaches will be cost-effective and what the impact of these interfaces will be on the adverse effects of NIV. KeywordsChildren, Long term non-invasive ventilation, Interface sleep fragmentation with daytime somnolence as well as chronic hypoxia resulting in pulmonary hypertension and cor pulmonale [4].

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“…Currently, measures to prevent PU consider the use of suitable masks, with strong evidence for the use of the total face mask model, as well as periodical revision of the skin and the placement of facial patches between the skin and the mask in risky areas 10,[16][17][18] . The protective patches are intended to create a physical barrier between the mask and the skin, in order to theoretically attenuate the pressure exerted on the skin, in an effect that we could call "meniscus effect", given the functional similarity achieved by the cartilaginous (meniscus) joint in the knee 19 .…”

Section: Face Protective Patches Do Not Reduce Facial Pressure Ulcersmentioning

confidence: 99%

Uso de parches protectores faciales no reduce la presión facial en un modelo simulado de ventilación mecánica no invasiva

Wood

et al. 2017

Rev. chil. pediatr.

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Background: Non-invasive mechanical ventilation (NIMV) frequently involves the development of pressure ulcer (PU) secondary to face-masks. Its prevention considers the empirical use of protective patches between skin and mask, in order to reduce the pressure exerted by face-masks. Objectives: To evaluate the effect of protective patches on the pressure exerted by face-masks, and its impact on ventilatory parameters. Method: A simulated model of BiPAP using total face mask on a training phantom with a physiological airway model (ALS PRO+) in supine position was used. The pressure on the front, chin and cheek was measured using 3 types of patches commonly used versus a control group, using pressure sensors (Interlinks Electronics(R)). The values obtained with the model of mask-protective patches in the programmed variables (peak inspiratory flow (PIF), expired tidal volume (Vte) and inspiratory positive pressure (IPAP)) were evaluated with a Trilogy 100 ventilator, Respironics(R). The programming and recording of the variables were carried out in 8 opportunities in each group by independent operators. Results: Any decrease in facial pressure with the protective patches used was observed, compared to the control group. Moltopren(R) increased facial pressure at all support points (p < 0.001), increased leakage, decreased PIF, Vte and IPAP (p < 0.001). Hydrocolloid patches increased facial pressure only in the left cheek, increased leakage and decreased PIF. Polyurethane patches did not produce changes in facial pressure or ventilatory variables. Conclusion: The use of Moltopren(R), hydrocolloid and transparent polyurethane protective patches did not contribute to the decrease on facial pressure. A deleterious effect of Moltopren and hydrocolloid patches was observed on the administration of ventilatory variables, concluding that the non-use of the protective patches allowed a better administration of the programmed parameters.

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How to avoid interface problems in acute noninvasive ventilation

Cited by 67 publications

References 39 publications

Evidence based synthesis for prevention of noninvasive ventilation related facial pressure ulcers

Evidence based synthesis for prevention of noninvasive ventilation related facial pressure ulcers

A Review of the Benefits, Challenges and the Future for Interfaces for Long Term Non-Invasive Ventilation in Children

Uso de parches protectores faciales no reduce la presión facial en un modelo simulado de ventilación mecánica no invasiva

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