Effect of Noninvasive Ventilation Mask Design on Upper Airway Washout: A Computational Fluid Dynamics Model.

Background: Noninvasive ventilation (NIV) is a primary treatment for patients with acute hypercapnic respiratory failure. Mask choice is fundamental in the success of NIV. Mask design can influence the fit, comfort, and venting of the instrumental dead space. A new mask has been designed to reduce e...

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Publicado en:Respiratory Care Vol. 70; no. 7; pp. 801 - 810
Autores principales: Clark, Alys R., O'Hagan, Lomani A., Fogarin, Jessica R., Gordon, James A., Miller, James C.D., Perera, Ashani M., Mirjalili, S. Ali
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jul2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2025
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      pub: Mary Ann Liebert, Inc.
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        10.1089/respcare.12421
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        atl: Effect of Noninvasive Ventilation Mask Design on Upper Airway Washout: A Computational Fluid Dynamics Model.
      aug:
        au:
          Clark, Alys R.
          O'Hagan, Lomani A.
          Fogarin, Jessica R.
          Gordon, James A.
          Miller, James C.D.
          Perera, Ashani M.
          Mirjalili, S. Ali
        affil: Dr. Clark is affiliated with Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
      sug:
        subj:
          Respiratory Failure Therapy
          Respiration, Artificial Methods
          Respiration, Artificial Equipment and Supplies
          Masks
          Equipment Design
          Airway Pressure
          Airway Resistance
          Physical Sciences
          Respiratory Protective Devices
          Human
          Funding Source
          Male
          Adult
          Nasal Cavity
          Nasopharynx Physiology
          Lung Physiology
          Computer Simulation
          Carbon Dioxide Metabolism
          Printing, Three-Dimensional
          Models, Theoretical
          Models, Biological
          Oxygen Therapy Methods
          Tomography, X-Ray Computed Methods
          Software
          Cross Sectional Studies
          Descriptive Statistics
          Comparative Studies
          Adult: 19-44 years
          Male
      ab: Background: Noninvasive ventilation (NIV) is a primary treatment for patients with acute hypercapnic respiratory failure. Mask choice is fundamental in the success of NIV. Mask design can influence the fit, comfort, and venting of the instrumental dead space. A new mask has been designed to reduce effect of anatomical dead space by washing out the airway of expired gases at end expiration. The aim of this investigation was to use computational fluid mechanics to model upper airway washout with different NIV mask designs. Methods: A 3D-printed head that represents the face and upper airways was used to construct 3D air space maps to be analyzed by computer simulation software when an individual is using each mask design. The 3D-printed head was mounted on a desktop lung simulator, measuring air flow and pressure at the mask and at the tracheal level during noninvasive therapies. Computational fluid dynamics was used to simulate air flow and CO2 distribution within the airway geometry and used to predict the impact of mask design on CO2 distribution within the upper airways. Results: The models predict distributions of CO2 through the upper airway geometry and show that because of the washout of expired gas in the nasal cavity, the novel mask improved CO2 concentrations at end expiration compared with conventional NIV. In simulations where the mouth and nasopharynx were both open, a 44% decrease in CO2 in the nasal cavities and a 28% decrease in CO2 over the entire upper airway geometry was predicted to result from this washout. Conclusions: Mask design can influence CO2 clearance in the upper airway. NIV with airway washout resulted in more CO2 clearance from the airway compared with a conventional NIV mask. Improved CO2 clearance may facilitate improved alveolar ventilation and subsequent gas exchange.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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