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Facial pressure zones of an oronasal interface for noninvasive ventilation: a computer model analysis* * Study carried out at the Faculdade de Engenharia da Universidade do Porto - FEUP, University of Porto Faculty of Engineering - branch of the nonprofit Instituto de Engenharia Mecânica - IDMEC, Mechanical Engineering Institute - Porto, Portugal; at the FEUP Faculty of Medicine São João Hospital, Porto, Portugal; and in the University of Aveiro Department of Engineering, Aveiro, Portugal ** *Trabalho realizado na Faculdade de Engenharia da Universidade do Porto - FEUP - ramo do Instituto de Engenharia Mecânica - IDMEC - sem fins lucrativos, Porto, Portugal; no Centro Hospitalar de São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; e no Departamento de Engenharia da Universidade de Aveiro, Aveiro, Portugal

OBJECTIVE:

To study the effects of an oronasal interface (OI) for noninvasive ventilation, using a three-dimensional (3D) computational model with the ability to simulate and evaluate the main pressure zones (PZs) of the OI on the human face.

METHODS:

We used a 3D digital model of the human face, based on a pre-established geometric model. The model simulated soft tissues, skull, and nasal cartilage. The geometric model was obtained by 3D laser scanning and post-processed for use in the model created, with the objective of separating the cushion from the frame. A computer simulation was performed to determine the pressure required in order to create the facial PZs. We obtained descriptive graphical images of the PZs and their intensity.

RESULTS:

For the graphical analyses of each face-OI model pair and their respective evaluations, we ran 21 simulations. The computer model identified several high-impact PZs in the nasal bridge and paranasal regions. The variation in soft tissue depth had a direct impact on the amount of pressure applied (438-724 cmH2O).

CONCLUSIONS:

The computer simulation results indicate that, in patients submitted to noninvasive ventilation with an OI, the probability of skin lesion is higher in the nasal bridge and paranasal regions. This methodology could increase the applicability of biomechanical research on noninvasive ventilation interfaces, providing the information needed in order to choose the interface that best minimizes the risk of skin lesion.

Noninvasive ventilation; Computer simulation; Respiration, artificial


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