Performance of Noninvasive Ventilation Masks in a Lung Model of COPD Exacerbation

Abstract

BACKGROUND: Noninvasive ventilation (NIV) reduces intubation and mortality in patients with COPD exacerbation who present with respiratory failure, and the type of mask may affect its success. Our objective was to compare the performance of 3 different NIV masks in a lung model. METHODS: We set the lung simulator mechanics and respiratory rate, and tested a small oronasal mask, a total face mask, and a large oronasal mask. We added CO 2 at a constant rate into the system and monitored the end-tidal carbon dioxide. We used a mechanical ventilator to deliver NIV in 8 different combinations of inspiratory effort, pressure support, and expiratory positive airway pressure. We measured end-tidal carbon dioxide mask leakage, tidal volume, trigger time, time to achieve 90% of the inspiratory target during inspiration, and excess inspiratory time. RESULTS: We presented the mean ؎ SD of the 8 simulated conditions for each mask. The mean ؎ SD leakage was higher for the total face mask (51 ؎ 6 L/min) than for the small oronasal mask (37 ؎ 5 L/min) and for the large oronasal mask (21 ؎ 3 L/min), P < .001; but end-tidal carbon dioxide and tidal volume were similar. The mean ؎ SD 90% of the inspiratory target during inspiration was faster for the small oronasal mask (585 ؎ 49 ms) compared with the large oronasal (647 ؎ 107 ms) and total face mask (851 ؎ 105 ms), P < .001, all other variables were similar. CONCLUSIONS: In this model, we found that the type of mask had no impact on CO 2 washout or on most synchrony variables.

Effect of non-invasive ventilator in combination with tiotropium bromide on pulmonary function and sleep quality of patients with chronic obstructive pulmonary disease complicated with obstructive sleep apnea-hypopnea syndrome

“…It has been reported that chronic obstructive pulmonary disease (COPD) occurs in about 200 million people worldwide, with incidence as high as 9-10 % in people over 40 years old [1][2][3][4]. It is a chronic respiratory inflammatory disease that seriously endangers human health.…”