[BobbyB]

Non-Invasive Mask Ventilation

Breathing is a function of the lungs as well as the muscles that move the chest and lungs. When certain diseases increase the work of breathing, the breathing muscles can tire. The respiratory system may be unable to function properly and breathing can become more difficult.

Your doctor has recommended the use of non-invasive mask ventilation to improve your breathing. Mask ventilation uses a machine that responds to your breathing efforts and delivers a deeper breath to your lungs. In this way, the machine can help you with breathing and give your respiratory muscles a chance to rest. As a result, you may be able to avoid frequent and repeated hospital stays. Non-invasive ventilation is not a life support system.

This therapy has been useful for patients with:

Neuromuscular diseases such as amyotrophic lateral sclerosis (ALS)
Chronic obstructive pulmonary disease (COPD)
Paralysis or fatigue of the diaphragm (diaphragmatic paralysis)
Decreased drive to breathe (central hypoventilation)
Some chest wall deformities (kyphoscoliosis, trauma)
Devices
There are many different devices available to assist your breathing. Your doctor and respiratory therapist will choose a device that best fits your needs. Most of the machines are small, portable, and easy to operate.

When to use the device
This therapy is most effective and best tolerated during sleep. Please refer to the instructions provided with your device for more information about how and when to use the machine.

Nasal interface
The most important part of your non-invasive ventilation system is the part that brings the air into contact with your face. This is usually a full or partial mask that fits over the nose or face, or nasal pillows that lie under the nostrils. The mask is secured with a cloth and velcro-adjusted headgear. Oxygen reaches the nasal mask, or pillows, through plastic tubing which is attached to the ventilator (see figure 1).

There are several makes and styles of nasal masks. Your doctor and respiratory therapist will help find the device that provides the most comfort while being effective.

Exhalation port
The exhalation port is another important part of the mask ventilation system. This port is designed to release the carbon dioxide you exhale from the system. Do not block or seal the slots on the exhalation port. Exhalation ports may either be built into the system or a separate adapter between the mask and plastic tubing.

Care of the equipment
Wash your mask or nasal pillows daily with mild soap and water. Since the headgear has many velcro adjustments, wash it by hand as needed. Tubing can also be cleaned regularly by using a mild detergent and rinsing thoroughly with water.

Common problems and concerns

Improper mask fit (Ask your respiratory therapist for help adjusting the mask. Or, try using a different style of mask.)
Noise from the machine
Feeling of claustrophobia from the mask and gas flow
Poor coordination of breathing due to anxiety
Practicing with the system for short periods of time may help you get used to the machine.

Cautions and hazards
Several conditions may affect the use of your mask ventilation system:

If a sinus infection or middle ear infection is present, please check with your doctor before using your machine.
If using a full face mask while sleeping, do not eat or drink for 2 to 3 hours before using the machine.
If you feel any chest discomfort, shortness of breath, or severe headache upon awakening when using the mask ventilation system, report these symptoms to your doctor immediately.
Common side effects

Skin irritation around the face
Ear discomfort from headgear
Eye inflammation
Skin abrasion
Watch for physical signs of respiratory distress when using the mask ventilation system, such as:

Increased abdominal distention (bulging of the stomach area as a result of pressure)
Faster breathing
Faster heart beat
Report any of these side effects or problems to your doctor.

Operating precautions

Always unplug the system before cleaning it.
Do not immerse the machine in water.
Do not put the filter back into the machine when it is wet.
Occasionally, patients require supplemental oxygen during mask ventilation therapy. Please review the precautions for oxygen therapy if appropriate.