Noninvasive ventilation is an effective treatment for a significant proportion of patients with acute respiratory failure. The success of noninvasive ventilation, however, depends on several factors, a major one being the selection of the proper interface. The choice and application of the interface in patients with acute respiratory failure is a considerable challenge for any treatment team. This review discusses the different types of interfaces that can be used in patients with acute respiratory failure, the differences between nasal, oro-nasal, and total face masks and the helmet, as well as the effect of interface type on treatment success and upper airway patency, mask fitting, problems related to the interface, and the relationship between ventilator type and interface choice.
BerryRB, ChediakA, BrownLK, FinderJ, GozalD, IberC, et al. Best clinical practices for the sleep center adjustment of noninvasive positive pressure ventilation (NPPV) in stable chronic alveolar hypoventilation syndromes. J Clin Sleep Med, 2010; 6(5):491–509.
2.
KushidaCA, ChediakA, BerryRB, BrownLK, GozalD, IberC, et al. Clinical guidelines for the manual titration of positive airway pressure in patients with obstructive sleep apnea. J Clin Sleep Med, 2008; 4(2):157–171.
3.
KeenanSP, SinuffT, BurnsKE, MuscedereJ, KutsogiannisJ, MehtaS, et al. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ, 2011; 183(3):E195–E214.
4.
BrillA-K. How to avoid interface problems in acute noninvasive ventilation. Breathe, 2014; 10:231–242.
5.
LemyzeM, MallatJ, NigeonO, BarraillerS, PepyF, GasanG, et al. Rescue therapy by switching to total face mask after failure of face mask-delivered noninvasive ventilation in do-not-intubate patients in acute respiratory failure. Crit Care Med, 2013; 41(2):481–488.
6.
BaHammamAS, SinghT, GeorgeS, AcostaKL, BaratamanK, GacuanDE. Choosing the right interface for positive airway pressure therapy in patients with obstructive sleep apnea. Sleep Breath, 2017; 10.1007/s11325-11017-11490-11329.
7.
OzsancakA, SidhomSS, LieschingTN, HowardW, HillNS. Evaluation of the total face mask for noninvasive ventilation to treat acute respiratory failure. Chest, 2011; 139(5):1034–1041.
8.
Esquinas RodriguezAM, PapadakosPJ, CarronM, CosentiniR, ChiumelloD. Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients. Crit Care, 2013; 17(2):223.
9.
PelosiP, SevergniniP, AspesiM, GamberoniC, ChiumelloD, FachinettiC, et al. Non-invasive ventilation delivered by conventional interfaces and helmet in the emergency department. Eur J Emerg Med, 2003; 10(2):79–86.
10.
DavidsonAC, BanhamS, ElliottM, KennedyD, GelderC, GlossopA, et al. BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults. Thorax, 2016; 71(Suppl 2):ii1–ii35.
11.
NavaS, NavalesiP, GregorettiC. Interfaces and humidification for noninvasive mechanical ventilation. Respir Care, 2009; 54(1):71–84.
12.
KwokH, McCormackJ, CeceR, HoutchensJ, HillNS. Controlled trial of oronasal versus nasal mask ventilation in the treatment of acute respiratory failure. Crit Care Med, 2003; 31(2):468–473.
13.
GiraultC, BrielA, BenichouJ, HellotMF, DachraouiF, TamionF, et al. Interface strategy during noninvasive positive pressure ventilation for hypercapnic acute respiratory failure. Crit Care Med, 2009; 37(1):124–131.
14.
AntonA, TarregaJ, GinerJ, GuellR, SanchisJ. Acute physiologic effects of nasal and full-face masks during noninvasive positive-pressure ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Respir Care, 2003; 48(10):922–925.
15.
SadeghiS, FakharianA, NasriP, KianiA. comparison of comfort and effectiveness of total face mask and oronasal mask in noninvasive positive pressure ventilation in patients with acute respiratory failure: a clinical trial. Can Respir J, 2017; 2017:2048032.
16.
CrimiC, NotoA, PrinciP, EsquinasA, NavaS. A European survey of noninvasive ventilation practices. Eur Respir J, 2010; 36(2):362–369.
17.
SilvaRM, TimenetskyKT, NevesRC, ShigemichiLH, KandaSS, MaekawaC, et al. Adaptation to different noninvasive ventilation masks in critically ill patients. J Bras Pneumol, 2013; 39(4):469–475.
18.
AntonelliM, ContiG, PelosiP, GregorettiC, PennisiMA, CostaR, et al. New treatment of acute hypoxemic respiratory failure: noninvasive pressure support ventilation delivered by helmet–a pilot controlled trial. Crit Care Med, 2002; 30(3):602–608.
19.
LiuQ, GaoY, ChenR, ChengZ. Noninvasive ventilation with helmet versus control strategy in patients with acute respiratory failure: a systematic review and meta-analysis of controlled studies. Crit Care, 2016; 20:265.
20.
AliA, TurkmenA, TurgutN, AltanA, SariT. [Comparison of non-invasive mechanical ventilation with helmet or face mask in patients with acute exacerbation of chronic obstructive pulmonary disease]. Tuberk Toraks, 2011; 59(2):146–152.
21.
ScandroglioM, PiccoloU, MazzoneE, AgratiP, AspesiM, GamberoniC, et al. Use and nursing of the helmet in delivering non invasive ventilation. Minerva Anestesiol, 2002; 68(5):475–480.
22.
OzlemCG, AliA, FatmaU, MehtapT, SaziyeS. Comparison of helmet and facial mask during noninvasive ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled study. Turk J Med Sci, 2015; 45(3):600–606.
23.
XuXP, ZhangXC, HuSL, XuJY, XieJF, LiuSQ, et al. Noninvasive ventilation in acute hypoxemic nonhypercapnic respiratory failure: a systematic review and meta-analysis. Crit Care Med, 2017; 45(7):e727–e733.
24.
PatelBK, WolfeKS, PohlmanAS, HallJB, KressJP. Effect of noninvasive ventilation delivered by helmet vs face mask on the rate of endotracheal intubation in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA, 2016; 315(22):2435–241.
25.
NicoliniA, FerraioliG, Ferrari-BravoM, BarlasciniC, SantoM, FerreraL. Early non-invasive ventilation treatment for respiratory failure due to severe community-acquired pneumonia. Clin Respir J, 2016; 10(1):98–103.
26.
NavalesiP, PolliniA. Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med, 2000; 162(2 Pt 1):761–762.
27.
KeenanSP, MehtaS. Noninvasive ventilation for patients presenting with acute respiratory failure: the randomized controlled trials. Respir Care, 2009; 54(1):116–126.
28.
MuradA, LiPZ, DialS, ShahinJ. The role of noninvasive positive pressure ventilation in community-acquired pneumonia. J Crit Care, 2015; 30(1):49–54.
29.
PrincipiT, PantanettiS, CataniF, EliseiD, GabbanelliV, PelaiaP, et al. Noninvasive continuous positive airway pressure delivered by helmet in hematological malignancy patients with hypoxemic acute respiratory failure. Intensive Care Med, 2004; 30(1):147–150.
30.
TacconeP, HessD, CaironiP, BigatelloLM. Continuous positive airway pressure delivered with a “helmet”: effects on carbon dioxide rebreathing. Crit Care Med, 2004; 32(10):2090–2096.
31.
HillNS. Noninvasive interfaces: should we go to helmets?. Crit Care Med, 2004; 32(10):2162–2163.
32.
AntonagliaV, FerlugaM, MolinoR, LucangeloU, PeratonerA, Roman-PognuzE, et al. Comparison of noninvasive ventilation by sequential use of mask and helmet versus mask in acute exacerbation of chronic obstructive pulmonary disease: a preliminary study. Respiration, 2011; 82(2):148–154.
33.
PisaniL, MegaC, VaschettoR, BelloneA, ScalaR, CosentiniR, et al. Oronasal mask versus helmet in acute hypercapnic respiratory failure. Eur Respir J, 2015; 45(3):691–699.
34.
VaschettoR, De JongA, ConseilM, GaliaF, MahulM, CoiselY, et al. Comparative evaluation of three interfaces for non-invasive ventilation: a randomized cross-over design physiologic study on healthy volunteers. Crit Care, 2014; 18(1):R2.
35.
BaHammamA, SyedS, Al-MughairyA. Sleep-related breathing disorders in obese patients presenting with acute respiratory failure. Respir Med, 2005; 99(6):718–725.
36.
WellmanA, GentaPR, OwensRL, EdwardsBA, SandsSA, LoringSH, et al. Test of the Starling resistor model in the human upper airway during sleep. J Appl Physiol, 2014; 117(12):1478–1485.
37.
AyappaI, RapoportDM. The upper airway in sleep: physiology of the pharynx. Sleep Med Rev, 2003; 7(1):9–33.
38.
JeffersonY. Mouth breathing: adverse effects on facial growth, health, academics, and behavior. Gen Dent, 2010; 58(1):18–25.
39.
AndradeRG, PiccinVS, NascimentoJA, VianaFM, GentaPR, Lorenzi-FilhoG. Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea. J Bras Pneumol, 2014; 40(6):658–668.
40.
LiangY, KimballWR, KacmarekRM, ZapolWM, JiangY. Nasal ventilation is more effective than combined oral-nasal ventilation during induction of general anesthesia in adult subjects. Anesthesiology, 2008; 108(6):998–1003.
41.
HessDR. How to initiate a noninvasive ventilation program: bringing the evidence to the bedside. Respir Care, 2009; 54(2):232–243.
42.
SchettinoGP, ChatmongkolchartS, HessDR, KacmarekRM. Position of exhalation port and mask design affect CO2 rebreathing during noninvasive positive pressure ventilation. Crit Care Med, 2003; 31(8):2178–2182.
43.
FodilR, LelloucheF, ManceboJ, Sbirlea-ApiouG, IsabeyD, BrochardL, et al. Comparison of patient-ventilator interfaces based on their computerized effective dead space. Intensive Care Med, 2011; 37(2):257–262.
44.
FraticelliAT, LelloucheF, L'HerE, TailleS, ManceboJ, BrochardL. Physiological effects of different interfaces during noninvasive ventilation for acute respiratory failure. Crit Care Med, 2009; 37(3):939–945.
45.
PisaniL, CarlucciA, NavaS. Interfaces for noninvasive mechanical ventilation: technical aspects and efficiency. Minerva Anestesiol, 2012; 78(10):1154–1161.
46.
CarronM, FreoU, BaHammamAS, DellwegD, GuarracinoF, CosentiniR, et al. Complications of non-invasive ventilation techniques: a comprehensive qualitative review of randomized trials. Br J Anaesth, 2013; 110(6):896–914.
47.
Esquinas RodriguezAM, ScalaR, SorokskyA, BaHammamA, de KlerkA, ValipourA, et al. Clinical review: humidifiers during non-invasive ventilation, key topics and practical implications. Crit Care, 2012; 16(1):203.
48.
HoffsteinV, VinerS, MateikaS, ConwayJ. Treatment of obstructive sleep apnea with nasal continuous positive airway pressure. Patient compliance, perception of benefits, and side effects. Am Rev Respir Dis, 1992; 145(4 Pt 1):841–845.
49.
StorreJH, BohmP, DreherM, WindischW. Clinical impact of leak compensation during non-invasive ventilation. Respir Med, 2009; 103(10):1477–1483.
50.
GonzalezJ, SharsharT, HartN, ChaddaK, RaphaelJC, LofasoF. Air leaks during mechanical ventilation as a cause of persistent hypercapnia in neuromuscular disorders. Intensive Care Med, 2003; 29(4):596–602.
OtoJ, ChenelleCT, MarcheseAD, KacmarekRM. A comparison of leak compensation in acute care ventilators during noninvasive and invasive ventilation: a lung model study. Respir Care, 2013; 58(12):2027–2037.
53.
VignauxL, TassauxD, JollietP. Performance of noninvasive ventilation modes on ICU ventilators during pressure support: a bench model study. Intensive Care Med, 2007; 33(8):1444–1451.
54.
MiyoshiE, FujinoY, UchiyamaA, MashimoT, NishimuraM. Effects of gas leak on triggering function, humidification, and inspiratory oxygen fraction during noninvasive positive airway pressure ventilation. Chest, 2005; 128(5):3691–3698.
55.
NavaS, BruschiC, FracchiaC, BraschiA, RubiniF. Patient-ventilator interaction and inspiratory effort during pressure support ventilation in patients with different pathologies. Eur Respir J, 1997; 10(1):177–183.
56.
LouisB, LerouxK, IsabeyD, FaurouxB, LofasoF. Effect of manufacturer-inserted mask leaks on ventilator performance. Eur Respir J, 2010; 35(3):627–636.
57.
Organized jointly by the American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Société de Réanimation de Langue Française, and approved by ATS Board of Directors, December 2000. International consensus conferences in intensive care medicine: noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med, 2001; 163(1):283–291.
58.
EvansTW. International consensus conferences in intensive care medicine: non-invasive positive pressure ventilation in acute respiratory failure. Organised jointly by the American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Société de Réanimation de Langue Française, and approved by ATS Board of Directors, December 2000. Intensive Care Med, 2001; 27(1):166–178.
59.
BransonRD, GentileMA. Is humidification always necessary during noninvasive ventilation in the hospital?. Respir Care, 2010; 55(2):209–216.
60.
CostaR, NavalesiP, SpinazzolaG, FerroneG, PellegriniA, CavaliereF, et al. Influence of ventilator settings on patient-ventilator synchrony during pressure support ventilation with different interfaces. Intensive Care Med, 2010; 36(8):1363–1370.
61.
RaccaF, AppendiniL, GregorettiC, StraE, PatessioA, DonnerCF, et al. Effectiveness of mask and helmet interfaces to deliver noninvasive ventilation in a human model of resistive breathing. J Appl Physiol, 2005; 99(4):1262–1271.
62.
NavalesiP, CostaR, CerianaP, CarlucciA, PrinianakisG, AntonelliM, et al. Non-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask. Intensive Care Med, 2007; 33(1):74–81.
63.
VargasF, ThilleA, LyazidiA, CampoFR, BrochardL. Helmet with specific settings versus facemask for noninvasive ventilation. Crit Care Med, 2009; 37(6):1921–1928.
64.
OlivieriC, CostaR, SpinazzolaG, FerroneG, LonghiniF, CammarotaG, et al. Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation. Intensive Care Med, 2013; 39(4):734–738.
65.
OlivieriC, LonghiniF, CenaT, CammarotaG, VaschettoR, MessinaA, et al. New versus conventional helmet for delivering noninvasive ventilation: a physiologic, crossover randomized study in critically ill patients. Anesthesiology, 2016; 124(1):101–108.
66.
PiquilloudL, TassauxD, BialaisE, LambermontB, SottiauxT, RoeselerJ, et al. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interaction during non-invasive ventilation delivered by face mask. Intensive Care Med, 2012; 38(10):1624–1631.
67.
CammarotaG, OlivieriC, CostaR, VaschettoR, ColomboD, TuruczE, et al. Noninvasive ventilation through a helmet in postextubation hypoxemic patients: physiologic comparison between neurally adjusted ventilatory assist and pressure support ventilation. Intensive Care Med, 2011; 37(12):1943–1950.
68.
SchmidtM, DresM, RauxM, Deslandes-BoutmyE, KindlerF, MayauxJ, et al. Neurally adjusted ventilatory assist improves patient-ventilator interaction during postextubation prophylactic noninvasive ventilation. Crit Care Med, 2012; 40(6):1738–1744.
69.
BertrandPM, FutierE, CoiselY, MateckiS, JaberS, ConstantinJM. Neurally adjusted ventilatory assist vs pressure support ventilation for noninvasive ventilation during acute respiratory failure: a crossover physiologic study. Chest, 2013; 143(1):30–36.
70.
DoorduinJ, SinderbyCA, BeckJ, van der HoevenJG, HeunksLM. Automated patient-ventilator interaction analysis during neurally adjusted non-invasive ventilation and pressure support ventilation in chronic obstructive pulmonary disease. Crit Care, 2014; 18(5):550.
71.
CammarotaG, LonghiniF, PeruccaR, RoncoC, ColomboD, MessinaA, et al. New setting of neurally adjusted ventilatory assist during noninvasive ventilation through a helmet. Anesthesiology, 2016; 125(6):1181–1189.
72.
SinderbyC, NavalesiP, BeckJ, SkrobikY, ComtoisN, FribergS, et al. Neural control of mechanical ventilation in respiratory failure. Nat Med, 1999; 5(12):1433–1436.
73.
GregorettiC, ConfalonieriM, NavalesiP, SquadroneV, FrigerioP, BeltrameF, et al. Evaluation of patient skin breakdown and comfort with a new face mask for non-invasive ventilation: a multi-center study. Intensive Care Med, 2002; 28(3):278–284.
74.
MuncktonK, HoKM, DobbGJ, Das-GuptaM, WebbSA. The pressure effects of facemasks during noninvasive ventilation: a volunteer study. Anaesthesia, 2007; 62(11):1126–1131.
HessDR. The evidence for noninvasive positive-pressure ventilation in the care of patients in acute respiratory failure: a systematic review of the literature. Respir Care, 2004; 49(7):810–829.
77.
DaiB, KangJ, YuN, TanW, ZhaoHW. Oxygen injection site affects FIO2 during noninvasive ventilation. Respir Care, 2013; 58(10):1630–1636.
78.
SchwartzAR, KacmarekRM, HessDR. Factors affecting oxygen delivery with bi-level positive airway pressure. Respir Care, 2004; 49(3):270–275.
79.
StorreJH, HuttmannSE, EkkernkampE, WalterspacherS, SchmoorC, DreherM, et al. Oxygen supplementation in noninvasive home mechanical ventilation: the crucial roles of CO2 exhalation systems and leakages. Respir Care, 2014; 59(1):113–120.
