Ventilator-Assisted Living©

Fall 2001, Vol. 15, No. 3

(continued)

German Pediatric Masks

Uwe Mellies, MD, Children's Hospital, University of Essen, Essen, Germany

In our programme, 40 children, adolescents, and young adults with congenital neuromuscular disorders use noninvasive mechanical ventilation. If possible, we prescribe commercial masks. If they do not fit or the child needs a mask without dead space, a dental technician makes a custom mask (photo 1).

Photo 1 of young girl with mask being prepared.

Twelve are using the Mirage® (ResMed) or Gold Seal® (Respironics, Inc.) nasal mask, 12 are ventilated with the Mirage® full face mask, 6 use a custom-made nasal mask, and 10 use a custom-made full face mask.

The custom masks are made of silicone by the dental technician from an individual impression of the child's nose or face (photos 2-4). The final mask is made from this impression, and it can be brightly colored. The process takes about two days but in an emergency it is also possible to build a simple mask at bedside.

Photo 2 of boy with custom mask being created. Photo 3 of mask being added over top of the boy's nose. Photo 4 of the completed mask.

These masks are comfortable and fit to our patients with facial dysmorphy. When mouth leak is a problem, we use a full face mask. The masks have no dead space. Triggering the ventilator becomes easy even for children with low tidal volumes.

Photo 5 - Man with nasal mask.Unfortunately, silicone and the production costs are rather expensive: a nasal mask (photo 5) is about $400 and a face mask about $600, but reimbursment has never been a problem for us. (For more details about the mask, contact Mr. Kruck, AirTec Beatmungshilfen, Mülheim an der Ruhr, Germany, info@beatmungshilfen.de, www.beatmungshilfen.de)

All our patients except two are using pressure preset ventilators: Sullivan VPAP® II (ResMed), Helia (Saime), BiPAP® Synchrony™ and Quantum® PSV (Respironics, Inc.).

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