Pneumologie
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Noninvasive mechanical ventilation with nasal or face mask using either BiPAP or IPPV (intermittent positive pressure ventilation) modes is meanwhile the standard type of mechanical ventilation instead of endotracheal intubation or tracheostomy in many patients with chronic and acute respiratory failure. However, problems occur very often in noninvasive mechanical ventilation due to mask problems with leakage of air out of the mask or erasions and necrosis of the skin by constant pressure through the mask frame. Hence, some clinical work groups developed customized molded masks mostly in cooperation with dentistry labs. These masks, however, are often very expensive and take several weeks to be manufactured. Our aim was to develop an inexpensive (less than 600 USS) and easy-(in one day)-to-produce customized nasal mask, the so-called "Freiburg nasal mask". We wish to show by a case report the clinical efficacy of this customized mask in severe respiratory failure. ⋯ This case shows that sometimes due to leakage of air in standard nasal masks noninvasive mechanical ventilation may fail in patients with severe respiratory failure. Therefore, in these patients customized moulded nasal or face masks should be used instead of standard masks. We think that the Freiburg nasal mask is an example of an easy to produce and nonexpensive customized mask and may be used in such patients, as this case report shows.