In Vitro Evaluation of Facial Pressure and Air Leak with a Newly Designed Cushion for Non-Invasive Ventilation Masks

• Main Authors: Hui-Ling Lin, Yu-Chi Lee, Ssu-Hui Wang, Li-Ying Chiang, Jui-Fang Liu
• Format: Article
• Language: English
• Published: MDPI AG 2020-12-01
• Series: Healthcare
• Subjects: non-invasive ventilation; interface; cushion; facial pressure; air leaks
• Online Access: https://www.mdpi.com/2227-9032/8/4/523

<i>Background:</i> The aim of this study was to evaluate the effect of a newly designed foam cushion on the air leakage and pressure when applied to the face. <i>Methods:</i> A teaching manikin connected to a bilevel positive airway pressure ventilator attached to four different brands of oronasal masks (Amara, Mirage, Forma, and Wizard) was used. The foam cushions of 5-mm and 10-mm-thickness were attached to the masks, and each mask was tested without a cushion. Six pressure sensors were placed on the manikin’s face, and data were recorded. Inspiratory volume and air leak flow from the ventilator were observed. <i>Results:</i> Air leakage was influenced by both the mask brand and the presence of a cushion. The presence of a cushion did not affect the Wizard mask in terms of leakage (<i>p</i> = 0.317) or inspiratory volume (<i>p</i> = 0.726). The Wizard and Amara masks generated the lowest contact pressure on the frontal forehead (<i>p</i> < 0.001) compared to the other five points. <i>Conclusions:</i> Utilisation of a cushion reduces air leakage and maintains greater inspiratory volume regardless of its thickness. The contact pressure varies depending on the brand of the mask, which would require a difference in the thickness of the cushion for pressure reduction.