Position of exhalation port and mask design affect CO2 rebreathing during noninvasive positive pressure ventilation

Critical Care Medicine
G P SchettinoR M Kacmarek

Abstract

Noninvasive positive pressure ventilation may be considered a first line intervention to treat patients with hypercapnic respiratory failure. However, CO2 rebreathing from the ventilator circuit or mask may impair CO2 elimination and load the ventilatory muscles. This study was conducted to evaluate the effect of exhalation port location and mask design on CO2 rebreathing during noninvasive positive pressure ventilation. Lung model evaluation. Experimental laboratory of a large university-affiliated hospital. A dual-chamber test lung was used to simulate the ventilatory mechanics of a patient with obstructive lung disease. Hypercapnic respiratory failure (end-tidal CO2 of 75 mm Hg) and obstructive lung disease were simulated in a double-chamber lung model. A facial mask (inner volume of 165 mL) with exhalation port within the mask (Facial-MEP) or the same mask with exhalation port in the ventilator circuit (Facial-WS) and a total face mask with exhalation port within the mask (inner volume 875 mL, Total Face) were tested during continuous positive airway pressure and pressure support ventilation provided by a single-limb circuit ventilator at the same frequency and tidal volume. A capnometer and a flow transducer were placed in...Continue Reading

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Related Concepts

Carbon Dioxide
Medical Device Design
Masks
Positive End-Expiratory Pressure
Mechanical Ventilation
Respiratory Function Tests
Respiratory Failure
Respiratory Mechanics

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