Noninvasive CPAP With Face Mask: Comparison Among New Air-Entrainment Masks and the Boussignac Valve

作者：Mistraletti Giovanni^*; Giacomini Matteo; Sabbatini Giovanni; Pinciroli Riccardo; Mantovani Elena S; Umbrello Michele; Palmisano Debora; Formenti Paolo; Destrebecq Anne L L; Iapichino Gaetano

来源：Respiratory Care, 2013, 58(2): 305-312.

DOI：10.4187/respcare.01598

• devices
• equipment
• development and evaluation/technology assessment
• PEEP
• CPAP
• noninvasive ventilation

BACKGROUND: The performances of 2 noninvasive CPAP systems (high flow and low flow air-entrainment masks) were compared to the Boussignac valve in 3 different scenarios. METHODS: Scenario 1: pneumatic lung simulator with a tachypnea pattern (tidal volume 800 mL at 40 breaths/min). Scenario 2: Ten healthy subjects studied during tidal breaths and tachypnea. Scenario 3: Twenty ICU subjects enrolled for a noninvasive CPAP session. Differences between set and effective CPAP level and F-IO2, as well as the lowest airway pressure and the pressure swing around the imposed CPAP level, were analyzed. The lowest airway pressure and swing were correlated to the pressure-time product (area of the airway pressure curve below the CPAP level) measured with the simulator. P-aO2 was a subject%26apos;s further performance index. RESULTS: Lung simulator: Boussignac F-IO2 was 0.54, even if supplied with pure oxygen. The air-entrainment masks had higher swing than the Boussignac (P = .007). Pressure-time product correlated better with pressure swing (Spearman correlation coefficient [rho] = 0.97) than with lowest airway pressure (rho = 0.92). In healthy subjects, the high-flow air-entrainment mask showed lower difference between set and effective F-IO2 (P %26lt; .001), and lowest airway pressure (P %26lt; .001), compared to the Boussignac valve. In all measurements the Boussignac valve showed higher than imposed CPAP level (P %26lt; .001). In ICU subjects the high-flow mask had lower swing than the Boussignac valve (P = .03) with similar P-aO2 increase. CONCLUSIONS: High-flow air-entrainment mask showed the best performance in human subjects. During high flow demand, the Boussignac valve delivered lower than expected F-IO2 and showed higher dynamic hyper-pressurization than the air-entrainment masks.

• 出版日期2013-2