There have been some attempts to produce personalized masks or mask cushions with 3D technology to enhance patient discomfort on account of an NIV nasal mask. Generally, the application of an NIV nasal mask is preferable for patients with obstructive sleep apnea who need long-term ventilation.25 On the other hand, an NIV oronasal mask is preferred for critically ill patients. Manufacturing a customized NIV oronasal mask is difficult since the facial shapes around both nose and mouth must be considered simultaneously. Although such patients are in a risky proposition for mask-related pressure ulcers, no study has reported the creation of a customized fitting device.
Creation of a Customized
In a randomized, cross-over experimental study, participants by having an NIV mask were randomly assigned to 2 groups. Those in the first group initially used a personalized fitting device relating to the face and also the mask and removed it later, whereas the other group used a personalized fitting device later and not initially. The study was separated into 2 phases: one phase involved the evaluation in the presence of blanchable erythema and associated discomfort, whereas one other phase involved the evaluation of contact pressure. Evaluation from the presence of blanchable erythema and discomfort level with or without the fitting device was performed to go out of no less than 24 hours to avoid any carryover effect.
Objective measurements in the face and custom face mask are needed to calculate the gap to create a personalised fitting device for each patient. For this purpose, computed tomography, magnetic resonance imaging, or even a 3D scanner can be utilized.
The incidence of blanchable erythema and standardized redness intensity values were significantly lower for subjects who used the fitting device when worn for 30 min. The discomfort levels at the forehead, nasal bridge, and both cheeks, and also leakage, were significantly reduced as well. Contact pressure on the nasal bridge, where pressure ulcers most often develop, was significantly decreased while using fitting device.