Brill Anne-Kathrin, Moghal Mohammad, Morrell Mary J, Simonds Anita K
Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Imperial College, London, UK.
Department of Pulmonary Medicine, University Hospital Bern, Bern, Switzerland.
Respirology. 2017 Oct;22(7):1343-1349. doi: 10.1111/resp.13074. Epub 2017 May 15.
A good mask fit, avoiding air leaks and pressure effects on the skin are key elements for a successful noninvasive ventilation (NIV). However, delivering practical training for NIV is challenging, and it takes time to build experience and competency. This study investigated whether a pressure sensing system with real-time visual feedback improved mask fitting.
During an NIV training session, 30 healthcare professionals (14 trained in mask fitting and 16 untrained) performed two mask fittings on the same healthy volunteer in a randomized order: one using standard mask-fitting procedures and one with additional visual feedback on mask pressure on the nasal bridge. Participants were required to achieve a mask fit with low mask pressure and minimal air leak (<10 L/min). Pressure exerted on the nasal bridge, perceived comfort of mask fit and staff- confidence were measured.
Compared with standard mask fitting, a lower pressure was exerted on the nasal bridge using the feedback system (71.1 ± 17.6 mm Hg vs 63.2 ± 14.6 mm Hg, P < 0.001). Both untrained and trained healthcare professionals were able to reduce the pressure on the nasal bridge (74.5 ± 21.2 mm Hg vs 66.1 ± 17.4 mm Hg, P = 0.023 and 67 ± 12.1 mm Hg vs 60 ± 10.6 mm Hg, P = 0.002, respectively) using the feedback system and self-rated confidence increased in the untrained group.
Real-time visual feedback using pressure sensing technology supported healthcare professionals during mask-fitting training, resulted in a lower pressure on the skin and better mask fit for the volunteer, with increased staff confidence.
良好的面罩贴合度、避免漏气以及压力对皮肤的影响是无创通气（NIV）成功的关键要素。然而，提供NIV的实践培训具有挑战性，且积累经验和能力需要时间。本研究调查了具有实时视觉反馈的压力传感系统是否能改善面罩贴合度。
在一次NIV培训课程中，30名医护人员（14名接受过面罩贴合培训，16名未接受过培训）以随机顺序在同一名健康志愿者身上进行两次面罩贴合操作：一次使用标准面罩贴合程序，另一次在鼻梁上有关于面罩压力的额外视觉反馈。参与者需要实现低面罩压力和最小漏气（<10升/分钟）的面罩贴合。测量施加在鼻梁上的压力、面罩贴合的感知舒适度以及工作人员的信心。
与标准面罩贴合相比，使用反馈系统时施加在鼻梁上的压力更低（71.1±17.6毫米汞柱对63.2±14.6毫米汞柱，P<0.001）。未接受培训和接受过培训的医护人员使用反馈系统时均能够降低鼻梁上的压力（分别为74.5±21.2毫米汞柱对66.1±17.4毫米汞柱，P=0.023；67±12.1毫米汞柱对60±10.6毫米汞柱，P=0.002），且未接受培训组的自我评定信心有所提高。
在面罩贴合培训期间，使用压力传感技术的实时视觉反馈为医护人员提供了支持，使志愿者皮肤上的压力更低、面罩贴合度更好，同时提高了工作人员的信心。
