Facial stress points of an oronasal interface for noninvasive ventilation: A computer model analysis

Background: The interface choice is a major cause of success or failure of noninvasive ventilation (NIV). The development of pressure-induced skin ulcers is one of the major complications during NIV. Objective: Analyze the main pressure zones (PZ), caused by an NIV oronasal mask (ONM), through a 3D computational model (CM) and in vitro sensor. Methodology: Both CM and in vitro model were able to assess the main pressure zones during NIV with a ONM. In the vitro model we used an oronasal mask (Quattro TM FX, ResMed) connected to a mannequin head and to evaluate the main PZ, a specific sensor (FUJI Film Prescaler) was used between the face and the ONM. The computational model was created through 3D laser scanning of the mannequin head and the ONM In order to obtain the PZ between them a simulation was created. Descriptive graphical images from the local areas of the PZ and their intensity were obtained. Results: Distribution of pressure was obtained, describing several PZ with greater relevance in the region of the nasal bridge and paranasal region. It was found a qualitative concordance between both models. In these regions we observed high values of pressure in the CM and in vitro model (0,41-0,55 Mpa). Conclusion: Higher probability of skin lesions occurrence at the level of the nasal bridge and the paranasal region. This methodology could be used in the future as a biomechanical engineering approach to create personalized interfaces, in order to minimize the appearance of skin lesions.