Background and rationale {6a}
skin damage, pain
PRESSURE ULCER, PRESSURE ULCERS, PRESSURE SORE, LEAKAGE
In recent years, noninvasive ventilation (NIV) has increasingly become a common approach for the treatment of hypercapnic [As patient comfort is a major factor for NIV success [The development of pressure ulcers is associated with adverse outcomes that may contribute to patient pain and suffering, impaired quality of life [Prevention is usually considered the most efficient solution to address pressure ulcers caused by NIV. Recommended preventative measures for skin damage due to pressure, friction, or shear include the following: (1) correct choice of interface and ventilator (2) reducing the time of uninterrupted NIV administration, (3) application of wound care dressing, and (4) absence of humidification. In particular, the interface should be chosen according to size and attachment. On the one hand, it should not be too loose to cause unintentional leakage, which would worsen patient-ventilator interaction. On the other hand, it should not be too tight to increase the risk of skin breakdown.As for the exposure time to the interface, a previous study assessing the incidence, location, and stage of pressure ulcers in ICU patients requiring NIV for > 24 h showed that the average exposure time for pressure ulcer development ranged from 1.25 to 74 h ( Even though interface rotation is generally accepted as a mean to improve NIV tolerance while reducing the risk of pressure sores [