Investigating the effects of strap tension during non-invasive ventilation mask application: a combined biomechanical and biomarker approach.
Investigating the effects of strap tension during non-invasive ventilation mask application: a combined biomechanical and biomarker approach.
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DOI：
10.2147/mder.s121712
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Bader DL
中科院分区：
文献类型：
--
作者：
Worsley PR;Prudden G;Gower G;Bader DL
无创通气通常用于呼吸支持。然而，在某些情况下，面罩应用可能会导致面部特定特征的压疮，导致疼痛和个人生活质量下降。本研究调查了面罩带张力对皮肤界面生物力学和生物标志物反应的影响。招募了健康参与者（n = 13），并以随机顺序分配了两种不同的面罩，这些面罩配备了三种条带条件，代表5 mm的增量以增加张力。在每个张力下戴口罩10分钟，然后是10分钟的不应期。设备-皮肤界面的评估包括测量鼻子和脸颊的压力、温度和湿度、从皮脂中收集的炎症细胞因子浓度和舒适度评分。结果表明，对于两种面罩，鼻梁处的界面压力显著高于脸颊处的界面压力（p < 0.05），鼻界面压力随着带张力的升高而显著增加（p < 0.05）。一种炎症细胞因子IL-1α在最高张力下面罩应用后增加，与基线相比中位数增加21%至33%。其他细胞因子显示出与绑带张力不太一致的趋势。参与者在统计学上报告了在升高的绑带张力期间更大的不适。面罩下的温度和湿度值从环境条件升高，尽管在面罩类型或带张力之间没有观察到差异。鼻梁上的骨性突起代表呼吸面罩应用期间皮肤的脆弱区域。这项研究表明，面罩带张力对施加在鼻子上的压力有显着影响。这可能导致皮肤表面的不适和炎症反应。需要进行进一步研究，以调查呼吸面罩在患有合并症的适当个体中的应用。
Non-invasive ventilation is commonly used for respiratory support. However, in some cases, mask application can cause pressure ulcers to specific features of the face, resulting in pain and reduced quality of life for the individual. This study investigated the effects of mask strap tension on the biomechanical and biomarker responses at the skin interface. Healthy participants (n = 13) were recruited and assigned two different masks in a random order, which were fitted with three strap conditions representing increments of 5 mm to increase tension. Masks were worn for 10 minutes at each tension followed by a 10-minute refractory period. Assessment at the device–skin interface included measurements of pressures at the nose and cheeks, temperature and humidity, a selection of inflammatory cytokine concentrations collected from sebum and scores of comfort. The results indicated significantly higher interface pressures at the bridge of the nose compared to the cheeks for both masks (p < 0.05), with nasal interface pressures significantly increasing with elevated strap tension (p < 0.05). One inflammatory cytokine, IL-1α, increased following mask application at the highest tension, with median increases from baselines ranging from 21 to 33%. The other cytokines revealed a less consistent trend with strap tension. The participants reported statistically greater discomfort during elevated strap tension. Temperature and humidity values under the mask were elevated from ambient conditions, although no differences were observed between mask type or strap tension. The bony prominence on the bridge of the nose represented a vulnerable area of skin during respiratory mask application. This study has shown that mask strap tension has a significant effect on the pressure exerted on the nose. This can result in discomfort and an inflammatory response at the skin surface. Further studies are required to investigate respiratory mask application for appropriate individuals with comorbidities.