Table 5.

Advantages and disadvantages of the various types of interfaces

Interface	Advantages	Disadvantages	Suggested ventilators and adjustments
Nasal	Less risk of aspiration	Mouth air leak	Continuous-flow single-limb circuit devices
	Facilitates expectoration	Depressurization through the mouth
	Less claustrophobia	Nose irritation
	Allows talking	Limited use in patients with nasal obstruction
	Allows eating	Mouth dryness
	Easy handling
	Less dead space
Facial	Less mouth air leak	Higher risk of pressure ulcer on the nose or support points	Continuous-flow or demand-flow devices
	More appropriate for acute conditions because it allows for greater flow rates and pressure levels	Greater claustrophobia	Single- or dual-limb circuit
		Greater risk of aspiration	When dual-limb circuit devices are used, leak automatic compensation in the circuit is necessary
		Hinders eating
		Hinders communication
		Risk of asphyxia in case of ventilator malfunction
		Risk of bronchial aspiration
Total-face	More comfortable for prolonged use	Greater dead space	Continuous-flow devices
	Easy to adjust	Should not be used in association with aerosol therapy	Single-limb circuit
	Less risk of face skin injury	Monitor for vomiting (attention to aspiration)	Use preferentially with NIV-specific ventilators or conventional ventilators with NIV module
	Minimum air leak
Helmet	More comfortable for prolonged use	Greater risk of CO2 rebreathing	Continuous-flow or demand-flow devices
	No risk of face or skin injury	Favors patient-ventilator asynchrony	Dual- or single-limb circuit with PEEP valve in the helmet
		Risk of asphyxia in case of ventilator malfunction
		Should not be used in association with aerosol therapy
		High internal noise and greater feeling of pressure in the ears
		Need of higher pressures to compensate for the dead space
		Skin injury can occur in the axillae

NIV - noninvasive ventilation; CO₂ - carbon dioxide; PEEP - positive end-expiratory pressure.