Page 235 - Clinical Application of Mechanical Ventilation

Noninvasive Positive Pressure Ventilation 201

TABLE 7-5 Advantages and disadvantages of the Oronasal mask

Advantage Disadvantage

Good seal Claustrophobia

More effective ventilation Patient noncompliance
Regurgitation and aspiration
Asphyxiation in power or gas outage
Alarm and monitor are necessary

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cheeks, they are an alternative to nasal, oronasal, or full-face masks. Since this
interface has a lower pressure range (e.g., 3 to 20 cm H O), nasal pillows devices
2
are not as effective as the larger nasal or oronasal mask when used in the bilevel
PAP mode. Some common complaints of nasal pillows are nasal congestion,
nose bleed, and dry or sore mouth. A humidifier or saline nasal spray may help
to minimize these side effects. Figure 7-3 shows the structure of nasal pillows
and Figure 7-4 shows the insertion, placement, and adjustment of this interface.
A chin strap to close the Nasal pillows devices are more comfortable than oronasal masks, but gas leak is
mouth or an oronasal mask
should be considered when a potential problem especially in men with beards and mustaches. If significant gas
gas leak through the mouth is
significant. leaks occur through the mouth, a chin strap may be used to close the mouth or an
oronasal mask should be considered.

G

F
H

E
I

J
K A

B
C D Image used by permission from Nellcor Puritan Bennett LLC, Boulder, Colorado, doing business as

A

Covidien.

Figure 7-3 Structure of a nasal pillows interface. (A) Nasal Pillows™; (B) Plenum shell;
(C) Vent-hole insert; (D) Wing knob (to adjust the angle of plenum shell); (E) Hose; (F) Hose guide;
(G) Outrigger; (H) Spine; (I) Swivel adapter; (J) Cradle; (K) Side straps.

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