Mask Interfaces for Noninvasive Mechanical Ventilation. Principles of Technology and Clinical Practice


Antonio M. Esquinas, MD, PhD, FCCP, FAARC Intensive Care Unit Hospital Morales Meseguer, Murcia, Spain; Director International School of Non-Invasive Ventilation; Director International Non Invasive Ventilation Expert of College

Series: Pulmonary and Respiratory Diseases and Disorders
BISAC: MED015000

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.

The book describes how mask interface technology influences noninvasive ventilation in four main aspects:

1) patient response (comfort, adaptation, noninvasive ventilation failure)
2) methodology (ventilatory modes, mechanical ventilators as a scientific reference for researchers, respiratory technicians and physicians)
3) New mask interface technology and new indications of noninvasive ventilation, and
4) Summary of key practical elements about mask interfaces to understand indications of noninvasive ventilation.

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Table of Contents


Section 1. Biomechanics of the Upper Airway: Physiology

Chapter 1. Basic Craniofacial and Upper Airway Structures. Anatomy and Physiologic Effects. Impact in Noninvasive Mechanical Ventilation
(Eunice Mendes – Department of Anaesthesiology – Coimbra Hospital and University Centre, Coimbra, Portugal)

Chapter 2. Physical Determinants of Upper Airways – Airflow and Pressure
(Fausta Viccaro and Francesco Vassalli – Department of Respiratory Diseases, Sapienza University, Umberto I Hospital, Rome, Italy, et al.)

Chapter 3. Noninvasive Mechanical Ventilation and Work of Breathing Patterns Using Different Interfaces
(Francisco Valdez Lima – Sciences and Technologies in Health Program, Department of Physical Therapy, University of Brasilia, Brasilia, DF, Brazil, et al.)

Section 2. Mask Interface: Technical Elements

Chapter 4. Interfaces: Design, Manufacturers and Headgear
(Luana Souto Barros and Thainná Nunes – AAME scientific committee, Rio de Janeiro, Brazil)

Chapter 5. Mask Interface – Air Leak Dynamics and Intentional Air Leaks
(Juliana Barata – Department of Pulmonology – Centro Hospitalar e Universitário Cova da Beira, Covilhã, Portugal)

Chapter 6. Carbon Dioxide Removal, Exhalation Ports, Oxygenation, and Air Leaks
(Mürüvvet Dayıoğlu and Müge Aydoğdu – Gazi University Medical Faculty, Critical Care Fellowship Program, Ankara, Turkey, et al.)

Chapter 7. Securing in Mask Interface Systems: Anti-Asphyxia Valve
(Raquel Viana – Department of Pulmonology, Leiria Hospital Center, Leiria, Portugal)

Section 3. Interface Options: Technology Interface – Noninvasive Ventilation

Chapter 8. Negative Noninvasive Ventilation-Cuirass: Design and Clinical Implications
(Umberto Vincenzi, Corrado Mollica and Antonio M. Esquinas – Operative Unit of Pneumology and Intensive Respiratory Care Unit. “Ospedali Riuniti” University Hospital. Foggia, Italy, et al.)

Chapter 9. Interface-Nasal Prongs: Designs and Clinical Implications
(Ana Craveiro and Margarida Afonso – Pneumology, University Hospital Center Cova da Beira, Covilhã, Portugal)

Chapter 10. Noninvasive Ventilation by Mouthpiece Ventilation
(Teresa Díaz de Terán López, Mónica González Martínez and Antonello Nicolini – Sleep disorders and Non Invasive Ventilation Unit, Pulmonology, Valdecilla Hospital, Santander, Spain, et al.)

Chapter 11. Noninvasive Ventilation by Helmet Interface
(Emanuele Rossetti – Pediatric Intensive Care Unit, DEA-ARCO Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy)

Chapter 12. Oronasal Face Masks Designs and Clinical Implications
(Deniz Çelik and Sezgi Şahin Duyar – Department of Pulmonology, Alanya Alaaddin Keykubat University, Alanya, Antalya, Turkey, et al.)

Chapter 13. Total Face Masks: Designs and Clinical Implications
(Maria Petraki and Dimitrios Lagonidis – ICU Mediteranneo Hospital, Athens, Greece, et al.)

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
(Rosana Mara da Silva and Thales Cantelle Baggio – Respiratory Physiotherapist, Municipal Health Department Jaraguá do Sul (SC), Brazil, et al.)

Chapter 15. Interface Pressures at the Bridge of the Nose: Prevention and Treatment
(Paolo Ruggeri and Francesco Nucera – Pneumology Unit, Pneumologia, Department BIOMORF, University of Messina, Messina, Italy)

Chapter 16. Mask Interface: Selection in Acute Respiratory Failure
(Catarina Mendes Silva – Department of Intensive Care, Coimbra Hospital and Universitary Centre, Coimbra, Portugal)

Section 5. Interface Tolerance: Noninvasive Ventilation Pattern of Response and Intolerance

Chapter 17. Mask Interface. Psychological Response – Claustrophobia/Anxiety – Diagnosis, Treatment, and Prevention
(Yoshinori Matsuoka, Kei Kurihara, Yoshitaka Nishiyama, and Takuma Sakai – Wide area medical corporation EMS)

Section 6. Interface: Evaluation and Monitoring

Chapter 18. Interfaces and Rebreathing: Evaluation of CO2 Washout
(Michalis Agrafiotis – Department of Respiratory Failure, Aristotle University of Thessaloniki, “Georgios Papanikolaou” General Hospital of Thessaloniki, Exohi, Greece)

Chapter 19. Effect of Mask Interface and Upper Airway Patency
(Vasileios Michailidis – Pulmonology Department, St. Luke’s Hospital, Thessaloniki, Greece)

Section 7. Mask Interface: Patient-Ventilator Interaction, Noninvasive Ventilation – Determinants

Chapter 20. Comfort: Mechanical Ventilator Triggering, Pressurization, and Synchrony
(Nikoletta Tyrovola, Eleni Nikoli and Nikolaos Schizas – Department of Anesthesiology, Evangelismos General Hospital, Athens, Greece, et al.)

Chapter 21. Terms of Effectiveness, Application, and Tolerability
(Raffaele Scala and Luca Guidelli – Pulmonology and Respiratory Intensive Care Unit, S Donato Hospital, Arezzo, Italy)

Chapter 22. Mask Interface – Leaks
(Sezgi Şahin Duyar and Deniz Çelik – Department of Pulmonology, University of Health Sciences, Atatürk Chest Diseases and Thoracic Surgery, Education and Research Hospital, Ankara, Turkey)

Section 8. Interface: Patient – Ventilatory Modes

Chapter 23. Continuous Positive Airway Pressure (CPAP)
(Marta Costa – Department of Internal Medicine, Hospital and University Centre, Coimbra, Portugal)

Chapter 24. Ventilatory Modes: Bi-Level Positive Pressure
(Elif Babaoglu – Department of Pulmonary Medicine, Hacettepe University, Ankara, Turkey)

Chapter 25. Ventilatory Modes, Neurally Adjusted Ventilatory Assist (NAVA)
(Vijay Hadda and Tejas Menon Suri – Associate Professor, Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India, et al.)

Section 9. Interface and Ventilator Settings

Chapter 26. Airway Pressure Waveform: Impact Positive Pressure/IPAP/Leakages – Higher IPAP Levels and Response
(Diogo Canhoto – Pulmonology Department, Coimbra Hospital and University Centre, Coimbra, Portugal)

Chapter 27. Nasal High Flow Treatments: Flow and Pressure Determinants
(Anna Annunziata, Pasquale Imitazione, Antonio Esquinas, and Giuseppe Fiorentino – Unit of Respiratory Physiopathology, Monaldi Hospital, Naples, Italy, et al.)

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
(Maurizio Moretti and Giancarlo Garuti – Pulmonology Unit, Santa Maria Bianca Hospital, Mirandola, MO, AUSL Modena, Italy)

Chapter 29. Noninvasive Ventilation in Hypercapnic Respiratory Failure: Summary and Practical Recommendations
(Sinem Nedime Sökücü – Medical Health Sciences, Yedikule Chest Disease and Thoracic Surgery, Training and Research Hospital, Istanbul, Turkey)

Chapter 30. The Mask Interface in Sleep Breathing Disorders
(Ahmet Cemal Pazarlı – Gaziosmanpaşa University, Department of Chest Diseases, Tokat, Turkey)

Chapter 31. The Mask Interface in Diagnostic/Therapeutic Procedures (Bronchoscopy, Nutrition)
(Agata Lax – Respiratory Rehabilitation Unit, IRCCS Fondazione Don Gnocchi, Milan, Italy)

Chapter 32. Mask Interface: Chronic Respiratory Failure – Home Mechanical Ventilation
(Biljana Lazovic, Radmila Dmitrovic, Isidora Simonovic and Antonio M. Esquinas – Department of pulmonology, University Clinical Center “Zemun,” Belgrade, Serbia, et al.)

Chapter 33. Mask Interface in Difficult Anatomic Conditions
(Iolanda Santos – Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal)

Chapter 34. Mask Interface and Noninvasive Ventilation Failure
(Anna Annunziata, Maurizia Lanza, Antonio Esquinas and Giuseppe Fiorentino – Respiratory Unit Monaldi Hospital, Naples, Italy, et al.)

Section 11. Complementary Technologies and Interface: Key Practical Relationships

Chapter 35. Humidification Devices
(Avşar Zerman – Assistant Professor, Department of Intensive care, Kırşehir Ahi Evran University, Training and Research Hospital, Kırsehir, Turkey)

Chapter 36. Aerosol Management during Noninvasive Mechanical Ventilation Therapy
(Abdul Rouf Pirzada and Ahmed S. BaHammam – Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia)

Chapter 37. Novel Tube Adapter for Noninvasive Mechanical Ventilation: Key Practical Relationships
(Oscar Iván Quintero Osorio and María Paula Garcia-Garcia – Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia)

Section 12. Mask Interface: Related Complications

Chapter 38. Noninvasive Mechanical Ventilation Interface: Acute Mask-Related Complications
(Nicola Vitulano – Cardiology and Intensive Care Unit, Ospedale Generale Regionale “F. Miulli,” Acquaviva delle Fonti (BA), Italy)

Chapter 39. Skin Breakdown, Facial Tissue Stresses: Medical Device-Related Pressure Ulcer, Prophylactic Dressings and Treatment
(Rita Queiroz Rodrigues – Department of Pneumology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal)

Chapter 40. Noninvasive Mechanical Ventilation Complications: Gastric Distension – Conjunctivitis
(Inês Rodrigues – Serviço de Pneumologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal)

Chapter 41. Chronic Prolonged Use of Noninvasive Mechanical Ventilation Masks
(Mariana Pires Asseiro – Department of Anaesthesiology – Coimbra Hospital and University Centre, Coimbra, Portugal)

About the Editor


Editor’s ORCID iD

Antonio M. Esquinas0000-0003-0571-2050

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