Nasal Mask Research Articles

0563 Exploring Trends of Oronasal versus Nasal Mask Use by Sleep Technologists

0563 Exploring Trends of Oronasal versus Nasal Mask Use by Sleep Technologists

Reducing Waste in Healthcare: A Systemic Design Approach for Sustainable Disposables Manufacturers

Efficient waste management is crucial in the healthcare system due to the complex composition and associated risks to workers, patients, and the environment. While there is growing awareness of the need to change the system, there is still an urgent need for a sustainable healthcare system. Sustainability concepts can guide designers in taking action, from considering waste reduction in the choice of materials to optimizing management systems through information and staff training. Systemic design methods can help involve business teams in the development of sustainable practices and strategies for production, use, and disposal. Research aimed to identify the types of disposables produced according to their polymers and weight, and to detect associated problems. The quantification of results led to the development of strategies aimed at reducing the number of polymer types used in product manufacturing with A case study on the Neonatal Nasal Mask, a consumable device was conducted to apply sustainable design strategies.

Nasal Cannula with Long and Narrow Tubing for Non-Invasive Respiratory Support in Preterm Neonates: A Systematic Review and Meta-Analysis.

Background: Cannulas with long and narrow tubing (CLNT) are increasingly being used as an interface for noninvasive respiratory support (NRS) in preterm neonates; however, their efficacy compared to commonly used nasal interfaces such as short binasal prongs (SBP) and nasal masks (NM) has not been widely studied. Material and Methods: Medline, Embase, CENTRAL, Health Technology Assessment Database, and Web of Science were searched for randomized clinical trials (RCTs) and observational studies investigating the efficacy of CLNT compared to SBP or NM in preterm neonates requiring NRS for primary respiratory and post-extubation support. A random-effects meta-analysis was used for data synthesis. Results: Three RCTs and three observational studies were included. Clinical benefit or harm could not be ruled out for the outcome of need for invasive mechanical ventilation (IMV) for CLNT versus SBP or NM [relative risk (RR) 1.37, 95% confidence interval (CI) 0.61–3.04, certainty of evidence (CoE) low]. The results were also inconclusive for the outcome of treatment failure [RR 1.20, 95% CI 0.48–3.01, CoE very low]. Oropharyngeal pressure transmission was possibly lower with CLNT compared to other interfaces [MD −1.84 cm H20, 95% CI −3.12 to −0.56, CoE very low]. Clinical benefit or harm could not be excluded with CLNT compared to SBP or NM for the outcomes of duration of IMV, nasal trauma, receipt of surfactant, air leak, and NRS duration. Conclusion: Very low to low CoE and statistically nonsignificant results for the clinical outcomes precluded us from making any reasonable conclusions; however, the use of CLNT as an NRS interface, compared to SBP or NM, possibly transmits lower oropharyngeal pressures. We suggest adequately powered multicentric RCTs to evaluate the efficacy of CLNT when compared to other interfaces.

Application of Nasal Mask in Painless Gastroscopy in Obese Patients

Application of Nasal Mask in Painless Gastroscopy in Obese Patients

Efficacy of Oxygen Delivered through High Flow Nasal Cannula versus Non Rebreathing Mask in Infants with Mild and Moderate Bronchiolitis: An Open-labelled Randomised Controlled Trial

Introduction: Bronchiolitis accounts for substantial portion of infant and paediatric hospital admissions worldwide. High flow nasal cannula is a relatively new, safe, comfortable and well tolerated mode of oxygen delivery for infants and children presenting with respiratory distress in emergency units and general wards. Aim: To compare the efficacy of oxygen delivered through high flow nasal cannula with non rebreathing mask in infants with mild and moderate bronchiolitis. Materials and Methods: This open-labelled randomised controlled trial was conducted among 80 infants under 12 months of age admitted with mild and moderate bronchiolitis in the well-equipped Paediatric Wards of Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India, from January 2017 to August 2018. Eligible recruited infants were randomised into two groups. First group receiving oxygen through Non Rebreathing Mask (NRM group) and second group receiving oxygen through High Flow Nasal Cannula (HFNC group). All the participants were followed-up with clinical examinations and investigations and outcomes were noted. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) software, Chi-square test and student's t-test used, p-value <0.05 was considered as statistically significant. Results: There was a significant reduction in duration of oxygen required in the HFNC group (mean duration in hours: 13.98±6.612) when compared to NRM group (mean duration in hours: 26.70±4.81). The mean length of hospital stay was lesser in HFNC group (3.65±1.460 days) when compared to NRM group (5.35±1.657 days). Comparison of heart rate between the two groups showed a statistically significant decrease in mean heart rate (144.0±7.2) as early as 2 hours (p-value 0.010) after initiation of HFNC when compared to NRM group (148.1±6.5). respiratory rate was significantly reduced when compared from 2 hours (p-value<0.001) of initiation of intervention, with HFNC group showing higher percentage of reduction in respiratory rate than NRM group. Mean SpO2 levels were higher in HFNC group when compared to NRM group at various time intervals, though not significant statistically. Conclusion: High flow nasal cannula, under monitoring, could safely be used in paediatric wards in infants and children with mild and moderate bronchiolitis.

Role of ventilator and nasal interface in pressure transmission during neonatal intermittent positive pressure ventilation: A bench study.

We aimed at evaluating pressure transmission and stability during non-synchronized neonatal nasal intermittent positive pressure ventilation (NIPPV) delivered using five mechanical ventilators and three nasal interfaces. An artificial nose-throat model was connected to a mechanical analog of the infant respiratory system and a breath generator. Ventilation was administrated via a nasal mask (NM), short bi-nasal prongs (SBN), or RAM® cannula. We applied positive end-expiratory pressures (PEEP) of 5 and 10 cmH2 O, inspiratory pressures (PIP) of 15 and 30 cmH2 O, inspiratory times of 0.23, 0.42, and 0.57 s. Measurements were performed with leaks of 0, 1.5, and 4 L/min. The pressure was measured at the airways opening (PAW ) and the glottis (PGL ).The difference between set and delivered pressures (PAW ) was less than ±1 cmH2 O for all ventilators. We documented a significant difference between PAW and PGL in the presence of leaks. With 4 L/min leaks, PEEP dropped by 43%, 49%, and 63% with NM, SBP, and RAM® cannula, respectively; PIP dropped by 58%, 64%, and 74%. On average, the SD of PEEP fluctuations was ±0.60 and ±2.50 cmH2 O for PAW and PGL ; the breath-by-breath SD of PIP was ±0.77 and ±2.06 cmH2 O. During NIPPV, the PIP and PEEP transmission to the glottis is markedly lower than the set values and highly variable. The impact of leaks and nasal interface is much more significant than the differences in ventilators' performance on the efficacy of pressure transmission and stability of non-synchronized ventilator-generated NIPPV.

Nasal Mask: An Alternative to Prevent Contagion during Essential Activities

Mexico ranks third in COVID-19 worldwide mortality [1]. After a year of the onset of the first cases, one of the main concerns of this global pandemic is to mitigate contagion...

Oronasal versus Nasal Masks for Non-Invasive Ventilation in COPD: A Randomized Crossover Trial.

PurposeThe impact of oronasal and nasal masks on the quality of nocturnal non-invasive ventilation (NIV) needs to be clarified. This trial was designed to compare the impact of oronasal and nasal masks on the objective quality and subjective acceptance of nocturnal NIV in COPD-patients.Patients and MethodsIn a randomized crossover trial, 30 COPD-patients with well-established high-intensity NIV (mean inspiratory/expiratory positive airway pressure 26±3/5±1 cmH2O, mean respiratory back-up rate 17±1/min) were ventilated for two consecutive nights on oronasal and nasal masks, respectively.ResultsFull polysomnography, nocturnal blood gas measurements, and subjective assessments were performed. There was a tendency towards improved sleep efficiency (primary outcome) when an oronasal mask was worn (+9.9%; 95% CI:-0.2%-20.0%; P=0.054). Sleep stages 3/4 were favored by the oronasal mask (+12.7%; 95% CI: 6.0%-19.3%; P=<0.001). Subjective assessments were comparable with the exception of items related to leakage (P<0.05 in favor of nasal masks). The mean transcutaneous PCO2 value for oronasal masks (47.7±7.4 mmHg) was comparable to that of nasal masks (48.9±6.6 mmHg) (P=0.11). There was considerable diversity amongst individual patients in terms of sleep quality and gas exchange following mask exchange. Subjective mask preference was not associated with sleep quality, but with nocturnal dyspnea. Over 40% of patients subsequently switched to the mask that they were not previously accustomed to.ConclusionIn general, oronasal and nasal masks are each similarly capable of successfully delivering NIV in COPD-patients. However, the individual response to different interfaces is extremely heterogeneous, while subjective mask preference is independent from objective measures, but associated with dyspnea.Trial RegistrationGerman Clinical Trials Registry (DRKS00007741).

Automatic Nasal PAP Mask Sizing with a Deep Unet.

We present the use of a deep Unet convolutional neural network as an automated way of sizing nasal Positive Airway Pressure (PAP) masks using facial images of patients. Using a VGG16 backbone the network was trained with the MUCT dataset and a significant amount of data augmentation. The trained model was then applied to a small custom dataset of PAP and non-PAP patients to predict the nose widths and corresponding PAP mask sizes of each subject. The Unet model produced a mask sizing accuracy of 63.73% (116/183) and a within one size accuracy of 88.5% (162/183).

Nasal mask vs binasal prongs for nasal continuous positive airway pressure in preterm infants: A systematic review and meta-analysis.

To investigate the effect of nasal continuous positive airway pressure (NCPAP) given with nasal masks (NM) compared with binasal prongs (BNP) on the incidence of intubation within 72 hours in preterm infants (primary outcome) via meta-analysis of clinical studies. We searched for randomized clinical trials (RCTs) or quasi-RCTs in Medline, PubMed, and Web of Science from inception through 4 December 2019. Two independent co-authors extracting data performed the meta-analysis using a fixed-effect model to yield pooled relative risk (RR) and its 95% confidence interval (CI) for each outcome. We used Cochrane GRADE to evaluate the evidence quality. Eleven RCTs met the inclusion criteria. The meta-analysis showed NCPAP provided via NM significantly reduced the rate of intubation within 72 hours (RR, 0.72; 95% CI, 0.58-0.90; nine studies; GRADE-moderate) and nasal trauma (RR, 0.64; 95% CI, 0.55-0.74; GRADE-low) compared with NCPAP provided via BNP. Also, NCPAP via NM significantly reduced surfactant treatment (RR, 0.85; 95% CI, 0.74-0.97; GRADE-very low) and bronchopulmonary dysplasia (RR, 0.47; 95% CI, 0.23-0.95; GRADE-low) compared with BNP in a setting where NCPAP was used as the primary support in respiratory distress syndrome. No statistically significant differences were noted between groups in secondary outcomes except increased NCPAP duration when NCPAP given with NM compared with BNP (mean difference [days], 1.78; 95% CI, 1.67-1.89; GRADE-low). Among premature infants, NCPAP provided with NM is more effective in preventing intubation and mechanical ventilation within 72 hours of initiating the support compared with NCPAP provided with BNP.

Randomized trial of mask or prongs for nasal intermittent mandatory ventilation in term infants with transient tachypnea of the newborn.

The aim of this study was to compare nasal masks (NM) with binasal prongs (NP) for applying nasal intermittent mandatory ventilation (NIMV) by assessing the duration of respiratory distress, rate of intubation, and nasal trauma in term infants with transient tachypnea of the newborn (TTN). Infants with a gestational age ≥37weeks and birthweight ≥2,000g who had NIMV administered for TTN were enrolled. We randomly allocated 80 neonates to the NM (n = 40) or NP (n = 40) group. Duration of respiratory distress was the primary outcome of this study. There were no statistically significant differences between the groups for the duration of tachypnea and NIMV (P = 0.94 and P = 0.13, respectively). No significant differences were observed between the two groups in terms of duration of oxygen supplementation and length of hospitalization (P = 0.72 and P = 0.70, respectively). The incidence of any grade of trauma and moderate trauma (grade II) was significantly higher in the NP group than in the NM group (P = 0.004 and P = 0.04, respectively). The rate of NIMV failure and other complications, including pneumothorax, pneumonia and feeding intolerance, was not significantly different in the groups. In term infants with TTN, delivering NIMV using NP in comparison to using NM appears to be similar with regard to the duration of respiratory distress and preventing intubation. However, the use of NP involves a greater risk of trauma than that of NM.

Comparison of the Efficacy of High-flow Nasal Oxygen Therapy and Facial Mask Ventilation on the Increase of the Oxygen Reserve Index During Anesthetic Induction

Comparison of the Efficacy of High-flow Nasal Oxygen Therapy and Facial Mask Ventilation on the Increase of the Oxygen Reserve Index During Anesthetic Induction

Modified Nasal Tse-PAP Mask Provides Continuous Active Oxygenation during Sedation, GA Induction and Difficult Intubation

Modified Nasal Tse-PAP Mask Provides Continuous Active Oxygenation during Sedation, GA Induction and Difficult Intubation

Comparison of High Flow Nasal Cannula and Standard Face Mask Oxygen Treatment in Children With Acute Bronchiolitis

Comparison of High Flow Nasal Cannula and Standard Face Mask Oxygen Treatment in Children With Acute Bronchiolitis

Validation of Novel Completely Sealed Nasal Positive Airway Pressure Device: SuperNO&amp;lt;sub&amp;gt;2&amp;lt;/sub&amp;gt;VA&amp;amp;trade; EtCO&amp;lt;sub&amp;gt;2&amp;lt;/sub&amp;gt; Measurement and Pressure Test Performance

Background: SuperNO2VA™ Et Nasal Mask (Vyaire Medical, Inc., United States) is a new nasal mask with an integrated sampling hood to capture exhaled gases and enable accurate measurements of end tidal carbon dioxide (EtCO2). The authors hypothesized that the SuperNO2VA Et design would measure EtCO2 more accurately than a predicate EtCO2 sampling line, the Smart CapnoLine® Plus, Adult/Intermediate CO2 Oral-Nasal Set (Medtronic, United States). Methods: A simulated patient setup enabled comparison of the accuracy of CO2 measurements within the SuperNO2VA Et and a predicate device for eight condition combinations of input CO2; breath rate and tidal volume (VT); and O2 flow rates. These tests were repeated with simulating Nasal Breathing and Oral Breathing. Results: Testing demonstrated that measurements of 1% and 5% input CO2 within the SuperNO2VA Et were accurate for a range of respiratory rates, VT, O2 flows, and CO2 concentrations. CO2 measurement errors were significantly larger for the Oral-Nasal Set compared to the SuperNO2VA Et for both 1% Input CO2 (-0.12%vol vs. -0.01%vol, p = 0.0005) and 5% Input CO2 (-0.93%vol vs. -0.08%vol, p 0.0001). At 5% Input CO2, eight of the 12 trials for the Oral-Nasal Set failed to meet the ISO accuracy specification, while all SuperNO2VA Et measurements met the specification. The accuracy of CO2 measurement within the SuperNO2VA were not different for Oral and Nasal Breathing trials for both CO2 concentration (1%: p = 0.33, 5%: p = 0.064). With the Oral-Nasal Set, CO2 measurements were lower during Oral compared to Nasal Breathing (1%: p = 0.0005, 5%: p = 0.0091). Conclusions: Based on performance outcomes, use of the SuperNO2VA Et offers significantly more accurate measurement of EtCO2 than the predicate EtCO2 sampling line. Measurements of EtCO2 within the SuperNO2VA Et are accurate over a range of CO2, breathing rates, tidal volumes, and O2 flows, as well as for nasal and oral breathing.

Comparision of High Flow Nasal Cannula and Standard Face Mask Oxygen Treatment in Children with Acute Moderate and Severe Bronchiolitis

Comparision of High Flow Nasal Cannula and Standard Face Mask Oxygen Treatment in Children with Acute Moderate and Severe Bronchiolitis

Evaluation of a New Nasal Pillows Mask for the Treatment of Obstructive Sleep Apnea

Evaluation of a New Nasal Pillows Mask for the Treatment of Obstructive Sleep Apnea

Prevention of leakage due to mouth opening through applying an oral shield device (Sominpax™) during nasal CPAP therapy of patients with obstructive sleep apnea

Background/objectiveThe first line treatment for obstructive sleep apnea (OSA) is nasal continuous positive airway pressure (nCPAP), for which a variety of masks are available. While nasal masks (NM) are the first choice; oronasal masks (ONM) are also frequently used to prevent mouth dryness resulting from mouth opening. Our cross-sectional, prospective, randomized, un-blinded study addressed the efficacy of wearing an oral shield in addition to NM in preventing mouth leakage MethodsPatients with OSA and established therapy using NM and complaining about mouth dryness (n = 29) underwent three polysomnographies (PSGs) using NM, ONM or a nose mask in combination with an oral shield (NMS). Mask leakage was continuously documented and objective sleep quality was assessed. ResultsThere were significant differences in the apnea-hypopnea-index (AHI) between ONM (8.5/h; SD 6,7) and NM/nasal mask combined with oral shield device (NMS) (2.6/h; SD 2,3; 2.7/h; SD 2,6) (p < 0,05) as well as in leakage [ONM (39.7 l/min SD 12,4); NM (34.6 l/min SD 9,4); NMS (33.1 l/min SD 9,6)] (p = 0.011). Furthermore, analysis of sleep quality (NREM3) favored NM and NMS over ONM (p = 0.02). There were no significant differences between NM and NMS in any objective outcome. ConclusionsOur data consistently confirmed the NM as the first choice for continuous positive airway pressure (CPAP) therapy of OSA. Notably, we demonstrated a high potential of the oral shield for patients with mouth opening to achieve additional comfort and thereby possibly compliance, without affecting nCPAP therapy effectiveness.

SuperNOVA Nasal Mask Ventilation Maintains Oxygenation during Deep Sedation in High-Risk Patients: A Case Series

SuperNOVA Nasal Mask Ventilation Maintains Oxygenation during Deep Sedation in High-Risk Patients: A Case Series

SuperNOVA Nasal Mask Ventilation Maintains Oxygenation during Deep Sedation in High-Risk Patients: A Case Series

SuperNOVA Nasal Mask Ventilation Maintains Oxygenation during Deep Sedation in High-Risk Patients: A Case Series