Respiratory Devices for Adults and Neonates in Intensive Care
Respiratory masks are often prescribed to individuals who require breathing support or medicinal interventions such as oxygen therapy. These devices are used on a variety of patients in the hospital setting from neonates with immature lungs, to elderly individuals with chronic respiratory problems.
Recent research has shown that respiratory support devices such as masks and nasal prongs can cause damage to the skin and underlying soft tissues when used for prolonged periods. Indeed, lesions on the bridge of the nose account for a large portion of mask complications, occurring in 5-30% of patients. The development of skin abrasions or necrosis is one factor that can limit the tolerance and duration of wearing the mask. Progressive tightening of the harness, increasing the air volume in the mask cushions, and increasing inspiratory pressure are factors that promote nasal pressure ulcers.
Pressure ulcers have been reported to occur in 23% of neonates in intensive care, with medical devices implicated in more than 50% of these cases
In neonates and paediatric patients, respiratory masks and nasal prongs are derived from scaled-down versions of adult devices. This has resulted in design features which are not suited for this vulnerable population. Pressure ulcers have been reported to occur in 23% of neonates in intensive care, with medical devices implicated in more than 50% of these cases. Several studies have found an association between respiratory devices and skin damage, with recent evidence highlighting over 40% of patients using respiratory masks and prongs exhibiting skin damage. The consequence of the trauma has, in some cases, necessitated cosmetic or functional surgery.
The MDVSN is working with clinical (Prof Howard Clark, Dr David Land), academic (Southampton) and industrial partners (Intersurgical Ltd) to provide innovative methods of design and manufacture of respiratory devices. The research currently being undertaken is focusing on two key areas, namely; (i) new and existing respiratory mask designs and (ii) new material polymers which match the compliance of the interfacial skin tissues. In order to provide further insight into the design features of the mask and their relative effects on the skin and soft tissues a combination of experimental and computational research is being conducted. This includes collaboration with Frazer-Nash Consultancy to develop a computational (FEA) model of the mask/head interface to predict the mechanical state of vulnerable facial tissues exposed to loading using respiratory devices.
Key facts
The Network is working with industrial partners and engineering consultants to evaluate performance of current respiratory devices.
