• de Macedo Bruno Rocha BR Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil., Francinni Mambrini Pires Rego, Fabia Diniz Silva, Juliana Valerio Pinaffi, and Juliana Carvalho Ferreira.
• Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. bruno.macedo@hc.fm.usp.br.
• Respir Care. 2019 Nov 1; 64 (11): 1416-1421.

BackgroundNoninvasive 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.MethodsWe 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 CO2 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.ResultsWe 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.ConclusionsIn this model, we found that the type of mask had no impact on CO2 washout or on most synchrony variables.Copyright © 2019 by Daedalus Enterprises.

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