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01-08-2016 | Original Article

Work of breathing using different interfaces in spontaneous positive pressure ventilation: helmet, face-mask, and endotracheal tube

Authors: Shinya Oda, Kei Otaki, Nozomi Yashima, Misato Kurota, Sachiko Matsushita, Airi Kumasaka, Hutaba Kurihara, Kaneyuki Kawamae

Published in: Journal of Anesthesia | Issue 4/2016

Abstract

Purpose

Noninvasive positive pressure ventilation (NPPV) using a helmet is expected to cause inspiratory trigger delay due to the large collapsible and compliant chamber. We compared the work of breathing (WOB) of NPPV using a helmet or a full face-mask with that of invasive ventilation by tracheal intubation.

Methods

We used a lung model capable of simulating spontaneous breathing (LUNGOO; Air Water Inc., Japan). LUNGOO was set at compliance (C) = 50 mL/cmH₂O and resistance (R) = 5 cmH₂O/L/s for normal lung simulation, C = 20 mL/cmH₂O and R = 5 cmH₂O/L/s for restrictive lung, and C = 50 mL/cmH₂O and R = 20 cmH₂O/L/s for obstructive lung. Muscle pressure was fixed at 25 cmH₂O and respiratory rate at 20 bpm. Pressure support ventilation and continuous positive airway pressure were performed with each interface placed on a dummy head made of reinforced plastic that was connected to LUNGOO. We tested the inspiratory WOB difference between the interfaces with various combinations of ventilator settings (positive end-expiratory pressure 5 cmH₂O; pressure support 0, 5, and 10 cmH₂O).

Results

In the normal lung and restrictive lung models, WOB decreased more with the face-mask than the helmet, especially when accompanied by the level of pressure support. In the obstructive lung model, WOB with the helmet decreased compared with the other two interfaces. In the mixed lung model, there were no significant differences in WOB between the three interfaces.

Conclusion

NPPV using a helmet is more effective than the other interfaces for WOB in obstructive lung disease.

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Title: Work of breathing using different interfaces in spontaneous positive pressure ventilation: helmet, face-mask, and endotracheal tube
Authors: Shinya Oda
Kei Otaki
Nozomi Yashima
Misato Kurota
Sachiko Matsushita
Airi Kumasaka
Hutaba Kurihara
Kaneyuki Kawamae
Publication date: 01-08-2016
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 4/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-016-2168-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Work of breathing using different interfaces in spontaneous positive pressure ventilation: helmet, face-mask, and endotracheal tube

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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