• Maria Aparecida Miyuki Nakamura, Eduardo Leite Vieira Costa, Carlos Roberto Ribeiro Carvalho, and Mauro Roberto Tucci.
• Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
• J Bras Pneumol. 2014 May 1;40(3):294-303.

ObjectiveDiscomfort and noncompliance with noninvasive ventilation (NIV) interfaces are obstacles to NIV success. Total face masks (TFMs) are considered to be a very comfortable NIV interface. However, due to their large internal volume and consequent increased CO2 rebreathing, their orifices allow proximal leaks to enhance CO2 elimination. The ventilators used in the ICU might not adequately compensate for such leakage. In this study, we attempted to determine whether ICU ventilators in NIV mode are suitable for use with a leaky TFM.MethodsThis was a bench study carried out in a university research laboratory. Eight ICU ventilators equipped with NIV mode and one NIV ventilator were connected to a TFM with major leaks. All were tested at two positive end-expiratory pressure (PEEP) levels and three pressure support levels. The variables analyzed were ventilation trigger, cycling off, total leak, and pressurization.ResultsOf the eight ICU ventilators tested, four did not work (autotriggering or inappropriate turning off due to misdetection of disconnection); three worked with some problems (low PEEP or high cycling delay); and one worked properly.ConclusionsThe majority of the ICU ventilators tested were not suitable for NIV with a leaky TFM.

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