Effect of Different Interfaces on FIO2 and CO2 Rebreathing During Noninvasive Ventilation. 2021

Li-Li Li, and Bing Dai, and Jie Lu, and Xin-Yu Li
Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of China Medical University, Shenyang, China.

BACKGROUND Improving [Formula: see text] and reducing CO2 rebreathing ([Formula: see text]) are the key means to improve the therapeutic efficacy of noninvasive ventilation (NIV). This study aimed to investigate the impact of interface design on [Formula: see text] and [Formula: see text] during NIV. METHODS A simulated lung model was established to analyze 17 different interfaces. CO2 was injected into the outlet of the simulated lung, and the noninvasive ventilator was connected to the simulated lung to simulate the application of NIV in patients with COPD with hypercapnia. [Formula: see text] and [Formula: see text] were calculated by mathematical integration of synchronously collected data pertaining to real-time pressure, flow, oxygen concentration, and CO2 concentration in the breathing circuit. Comparisons were performed between different types (nasal vs oronasal) and models of interfaces as well as between interfaces with different leak positions. Correlation of [Formula: see text] and [Formula: see text] with inner volume and leakage, respectively, and the correlation between [Formula: see text] and [Formula: see text] were analyzed. RESULTS [Formula: see text] levels were significantly different with a nasal or an oronasal mask (0.45 ± 0.05% vs 0.41 ± 0.08%, respectively; P < .001). [Formula: see text] levels associated with different models of interfaces varied significantly (all P < .001); [Formula: see text] did not differ significantly among the different interfaces (P = .19). Leak position significantly affected [Formula: see text] and [Formula: see text] (all P < .001). Both inner volume and leakage significantly correlated with [Formula: see text] (r = -0.23, P < .001; r = -0.08, P = .02). There was a significant correlation between [Formula: see text] and [Formula: see text] (r = 0.43, P < .01); the general linear equation was y = 0.17 + 0.02x (r = 0.43, R2 = 0.19). CONCLUSIONS The design of the interface had a significant impact on [Formula: see text] and [Formula: see text] during NIV. [Formula: see text] and [Formula: see text] showed a significant positive correlation, although the effect size of correlation was moderate.

UI MeSH Term Description Entries
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012122 Ventilators, Mechanical Mechanical devices used to produce or assist pulmonary ventilation. Mechanical Ventilator,Mechanical Ventilators,Respirators,Ventilators, Pulmonary,Pulmonary Ventilator,Pulmonary Ventilators,Ventilator, Pulmonary,Ventilators,Respirator,Ventilator,Ventilator, Mechanical
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D063087 Noninvasive Ventilation Techniques for administering artificial respiration without the need for INTRATRACHEAL INTUBATION. Non Invasive Ventilation,Non-Invasive Ventilation,Non Invasive Ventilations,Non-Invasive Ventilations,Noninvasive Ventilations,Ventilation, Non Invasive,Ventilation, Non-Invasive,Ventilation, Noninvasive,Ventilations, Non Invasive,Ventilations, Non-Invasive,Ventilations, Noninvasive

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