In noninvasive mechanical ventilation, the mask interface selection and design are the first physical contact with the patient and the more relevant determinant in their tolerance and response. There are a great number of designs and studies that focus on this topic. However, there is no practical book that incorporates deep analysis, rational physical determinants and patients’ responses. This book aims to offer comprehensive expert review chapters on the most significant recent developments in the field of mask interfaces for noninvasive mechanical ventilation, detailing the technology, practices and clinical implications in pulmonary and critical care by providing clear insights and interpretations. Chapters are intended to serve as a reference to those involved in technology, mask selection and patient interaction to properly deliver noninvasive ventilation (incorporating comfort, gas exchange, work of breathing, lung physiology, and interactions of positive pressure) in treatment of acute and chronic respiratory disorders. This aims to offer physicians and researchers a key cornerstone book to understand the basic technology of noninvasive ventilation interfaces and noninvasive ventilation response.
Author(s): Antonio M. Esquinas
Series: Pulmonary and Respiratory Diseases and Disorders
Publisher: Nova Science Publishers
Year: 2022
Language: English
Pages: 369
City: New York
Contents
Preface
Section 1. Noninvasive Ventilation Mask Interface: Biomechanics of the Upper Airway ( Physiology
Chapter 1
Basic Craniofacial and Upper Airway Structures:
Anatomy and Physiologic Effects ( Impact in Noninvasive Mechanical Ventilation
Abstract
Introduction
The Nose
Nasal Cavity
Lateral Walls
Posterior Nares (Choana)
Function of the Nose
The Pharynx
Nasopharynx
Oropharynx
Hypopharynx
The Larynx
Functions of the Larynx
Laryngeal Skeleton
Glottis
Muscles of the Larynx
Nerve Supply of the Larynx
Conclusion
References
Chapter 2
Physical Determinants of Upper Airways: Airflow and Pressure
Abstract
Introduction
Pressure, Volume and Flow in the Upper Airways
Elastic Properties
Dynamic Properties
Upper Airways Critical Pressure
Fixed and Variable Airway Obstruction
Conclusion
References
Chapter 3
Noninvasive Mechanical Ventilation and Work of Breathings Patterns Using Different Interfaces
Abstract
Introduction
Comparison between NIV Interfaces - Scientific Evidences
Conclusion
References
Section 2. Mask Interface: Technical Elements
Chapter 4
Interfaces: Design, Manufacturers and Headgear
Abstract
Introduction
Conclusion
References
Chapter 5
Mask Interface: Air Leak Dynamics and Intentional Air Leaks
Abstract
Introduction
Intentional Leaks
Unintentional Leaks
Conclusion
References
Chapter 6
Carbon Dioxide Removal, Exhalation Ports, Oxygenation, and Air Leaks
Abstract
Introduction
Carbon Dioxide Removal and Rebreathing
Exhalation Ports
Oxygenation
Air Leaks
Conclusion
References
Chapter 7
Securing in Mask Interface Systems: Anti-Asphyxia Valve
Abstract
Introduction
Technical and Safety Aspects
Types of Circuits: Double and Single-Limb Circuits
Vented and Non-Vented Masks
Droplet Generation and Airborne Disease
Other Safety Considerations
Conclusion
References
Section 3. Interface Options: Technology Interface ( Noninvasive Ventilation
Chapter 8
Negative Noninvasive Ventilation-Cuirass:
Design and Clinical Implications
Abstract
Introduction
Ventilatory Mechanics
Clinical Implications of Ventilators with Extratoracic Action
The “Iron Lung”
The “Poncho” or “Pneumowrap”
The Curiass
The Hayek Cuirass with High Oscillatory Frequency
Double Positive + Negative Synchronized Ventilation (DPNSV)
Conclusion
References
Chapter 9
Interface-Nasal Prongs: Designs and Clinical Implications
Abstract
Introduction
Design and Technical Characteristics
Clinical Implications
Conclusion
References
Chapter 10
Noninvasive Ventilation by Mouthpiece Ventilation
Abstract
1. Introduction
2. General Points Regarding MPV
3. Indications and Contraindications of MPV
4. Technique and Adaptation
4.1. Types of Mouthpieces
4.2. Ventilator Parameters
4.3. Alarms
4.4. MPV according to Different Diseases/Situations
4.4.1. Amyotrophic Lateral Sclerosis (ALS)
4.4.2. Spinal Muscular Atrophy (SMA)
4.4.3. Duchenne Muscular Dystrophy (DMD)
4.4.4. Other NMD’s
4.4.5. Chronic Obstructive Pulmonary Disease (COPD)
4.4.6. Acute Care
5. Limitations
Conclusion
References
Chapter 11
Noninvasive Ventilation by Helmet Interface
Abstract
Introduction- Adult Helmet
Pediatric Helmet
Conclusion
References
Chapter 12
Oronasal Face Masks Designs and Clinical Implications
Abstract
Introduction
The History of Oronasal Face Masks
Designs of Oronasal Face Masks
Clinical Implications of Oronasal Face Masks
Conclusion
References
Chapter 13
Total Face Masks: Designs and Clinical Implications
Abstract
Abbreviations
Introduction
Design of the Total Face Mask
Unintentional Leaks and Total Face Masks
Dead Space and CO2 Elimination
Total Face Mask and Upper Airway Patency
The Effect of Interface on Airway Humidity
Patient Comfort and Skin Lesions
Effectiveness
Practical Issues
Conclusion
References
Section 4. Methodology and Practical Tools for Noninvasive Ventilation: Choice of Interface and Effectiveness ( Practical Recommendations, Interface, Practice
Chapter 14
Interface-Mask Fitting: Effects of Mask Strap Tension on the Biomechanical and Biomarkers ( Skin Interface
Abstract
Introduction
Studies and Methods
Conclusion
References
Chapter 15
Interface Pressures at the Bridge of the Nose: Prevention and Treatment
Abstract
Introduction
Epidemiology
Pathogenesis and Risk Factors
Prevention and Treatment Strategies
NIV Interface Selection
Patient Setting
Training in Patient Management during NIV of Health-Care Staff
Skin Protective Strategies
Differentiation of Problems between Adult and Pediatric Patients
Conclusion
Key Messages
References
Chapter 16
Mask Interface: Selection in Acute Respiratory Failure
Abstract
Introduction
Interface Selection
Hypercapnic Acute Respiratory Failure
Acute Cardiogenic Pulmonary Edema
De Novo Hypoxemic ARF
HFNC versus NIV
Oronasal versus Nasal 7K
Oronasal versus Total Face 7K
Oronasal 7K versus Helmet
Postoperative Period
Post-Extubation
Immunosuppression
Pandemic Viral Illness
Conclusion
References
Section 5. Interface Tolerance: Noninvasive Ventilation ( Pattern of Response and Intolerance
Chapter 17
Mask Interface: Psychological Response ( Claustrophobia/Anxiety ( Diagnosis, Treatment, and Prevention
Abstract
Introduction
Symptoms
Causes
Diagnosis
NIV Claustrophobia
Treatment and Prevention
Desensitization
Wearing Mask while Awake
Conclusion
References
Section 6. Interface: Evaluation and Monitoring
Chapter 18
Interfaces and Rebreathing: Evaluation of CO2 Washout
Abstract
Abbreviations
Introduction
1. Standard Masks
1.1. Type of Exhalation Device and Expiratory Positive Airway Pressure
1.2. Position of Exhalation Device
1.3. Mask Internal Volume
1.4. Ventilatory and Gas Exchange Parameters
2. Helmets
Conclusion
References
Chapter 19
Effect of Mask Interface and Upper Airway Patency
Abstract
Abbreviations
Introduction
NIV and Upper Airway Patency
Mask Interfaces and Upper Airway Patency
Studies about the Effect of Different Interfaces on NIV and Upper Airway Patency
Conclusion
References
Section 7. Mask Interface: Patient-Ventilator Interaction, Noninvasive Ventilation ( Determinants
Chapter 20
Comfort: Mechanical Ventilator ( Triggering, Pressurization, and Synchrony
Abstract
Introduction
Methods
Mask Interfaces for Noninvasive Mechanical Ventilation
Types of Interfaces
Patient Comfort & Efficiency
Patient-Ventilator Interaction
Triggering of the Ventilator
Cycling-off Criterion
Airway Pressure during NIV
Synchrony
Triggering Delay and Ineffective Triggering
Double Triggering
Auto-Triggering
Conclusion
References
Chapter 21
Terms of Effectiveness, Application, and Tolerability
Abstract
Introduction
General Considerations
Oral Interfaces
Nasal Masks and Pillows
Oronasal and Total Face Masks
Helmets
Conclusion
References
Chapter 22
Mask Interface: Leaks
Abstract
Introduction
Types of the Leak
Factors Related to the Leak
Effects of the Leak
Interventions to Reduce the Leak
Conclusion
Key Messages
References
Section 8. Interface: Patient ( Ventilatory Modes
Chapter 23
Continuous Positive Airway Pressure (CPAP)
Abstract
Introduction
Indications
Acute Cardiogenic Pulmonary Edema
Obstructive Sleep Apnea
Obesity Hypoventilation Syndrome
Pos-Extubation
Neonatal Intensive Care
Contraindications
Complications
Conclusion
References
Chapter 24
Ventilatory Modes: Bi-Level Positive Pressure
Abstract
Introduction
BIPAP
Physiology of BIPAP
BIPAP Devices and Modes
Indications of BIPAP
Application of BIPAP
Advantages of BIPAP
Contraindications of BIPAP
Conclusıon
References
Chapter 25
Ventilatory Modes, Neurally Adjusted Ventilatory Assist (NAVA)
Abstract
Introduction - NAVA
Does Interface Matter in Noninvasive Ventilation for Acute Respiratory Failure?
Oronasal Mask
Nasal Mask
Full-Face Mask
Helmet
Current Evidence of NAVA-NIV and the Impact of Interfaces
NAVA-NIV using Oronasal Mask
NAVA-NIV with Helmet
Conclusion
References
Section 9. Interface and Ventilator Settings
Chapter 26
Airway Pressure Waveform: Impact Positive Pressure/IPAP/Leakages ( Higher IPAP Levels and Response
Abstract
Introduction
Airway Pressure Waveform
Patient-Ventilator Asynchrony
Circuit Leak
Conclusion
References
Chapter 27
Nasal High Flow Treatments:
Flow and Pressure Determinants
Abstract
Abbreviations
Introduction
Flow Study in Laboratory
The Outcome of Flow and Cannula Size on Produced Pressure during Nasal High Flow
Reduce Dead Space
Conclusion
References
Section 10. Interface Bench and Clinical Data and Type Respiratory Failure: Recommendations and Results
Chapter 28
Interface in Noninvasive Ventilation in Hypoxemic Respiratory Failure: Summary and Practical Recommendations
Abstract
Introduction
Interfaces in Adult
Comparison among Masks
Limitations and Practical Recommendations
Comparison between Helmet and Other Mask Interfaces
Helmet NIV Limitations and Practical Recommendations
Interfaces in Pediatric Setting
NIV in COVID-19 Patients: Safety and Precautions
Conclusion
References
Chapter 29
Noninvasive Ventilation in Hypercapnic Respiratory Failure: Summary and Practical Recommendations
Abstract
Introduction
COPD
Cardiogenic Pulmonary Edema
Acute Asthma Exacerbation
Immunocompromised Patients
Post-Operative Patients
Palliative Care
Chest Trauma
Post-Extubation Respiratory Failure
Weaning from IMV
Conclusion and Recommendations
References
Chapter 30
The Mask Interface in Sleep Breathing Disorders
Abstract
1. Introduction
2. Type of Masks
2.1. Nasal Masks (NM)
2.2. Oronasal Masks (ONM)
2.3. Nasal Pillow Masks (NPM)
2.4. Oral Masks (OM)
2.5. Total Face Masks (TFM)
Discussion and Conclusion
References
Chapter 31
The Mask Interface in Diagnostic/Therapeutic Procedures (Bronchoscopy, Nutrition)
Abstract
Introduction
Fiberoptic Bronchoscopy during NIV
Other Endoscopy Procedures
Key Messages
References
Chapter 32
Mask Interface: Chronic Respiratory Failure ( Home Mechanical Ventilation
Abstract
Abbreviations
Introduction
CRF, Definition and Characteristics
A Brief Review of Pathophysiology
HMVs-Brief View
Home Ventilation in COPD.
Conclusion
Key Recommendations
References
Chapter 33
Mask Interface in Difficult Anatomic Conditions
Abstract
Introduction
Interfaces
Difficult Anatomic Conditions
Conclusion
References
Chapter 34
Mask Interface and Noninvasive Ventilation Failure
Abstract
Abbreviations
Introduction
Factors Related to the Type of Mask in Different Settings
Upper Airway Obstruction
Skin Breakdown
Air Leaks
Conclusion
References
Section 11. Complementary Technologies and Interface: Key Practical Relationships
Chapter 35
Humidification Devices
Abstract
Introduction
Humidification
Humidification Devices
Humidification and Noninvasive Ventilation
Conclusion
Key Points
References
Chapter 36
Aerosol Management during Noninvasive Mechanical Ventilation Therapy
Abstract
Introduction
Aerosols
At Home
In Hospital
Environmental Control in Hospitals, HVAC etc.
Management Strategies According to Various Organizations Can
Be Summarized
Ventilation
Humidification and Temperature
UV Light
Conclusion
Conflict of Interest
Sources of Funding
References
Chapter 37
Novel Tube Adapter for Noninvasive Mechanical Ventilation: Key Practical Relationships
Abstract
Introduction
Pathophysiology
Conclusion
References
Section 12. Mask Interface: Related Complications
Chapter 38
Noninvasive Mechanical Ventilation Interface: Acute Mask-Related Complications
Abstract
Introduction
Interface Mask-Related Complications
Nasal Symptoms
Unintentional Leak
Mask Displacement
Mid Face Hypoplasia
Conclusion
References
Chapter 39
Skin Breakdown, Facial Tissue Stresses: Medical Device-Related Pressure Ulcer, Prophylactic Dressings and Treatment
Abstract
Introduction
Methods
Pressure Ulcer: Definition, Classification and Physiopathology
Epidemiology
Interface Selection
Risk Factors for Facial Skin Breakdown Development
Risk Assessment
Prevention of NIV Device-Related Pressure Ulcers
Treatment
Conclusion
References
Chapter 40
Noninvasive Mechanical Ventilation Complications:
Gastric Distension ( Conjunctivitis
Abstract
Introduction
Gastric Distention
Conjunctivitis
Conclusion
References
Chapter 41
Chronic Prolonged Use of Noninvasive Mechanical Ventilation Masks
Abstract
Introduction
Interface- Chronic Prolonged Use of NIV Masks Related Complications
Related to the Interface
Related to the Air Pressure and Flow
Related to the Patient
Conclusion
References
About the Editor
Index
Blank Page
