Why might high mask leakage occur during NIV?

High mask leakage during noninvasive ventilation (NIV) is primarily attributed to poor mask fit or adjustment. When the mask does not conform properly to the patient's face, it creates gaps that allow air to escape, leading to ineffective ventilation and potential discomfort for the patient. A well-fitted mask is crucial to maintain a proper seal, which helps ensure that the delivered pressure remains consistent and effective.

Inadequate adjustment can occur if the straps are set too loose, or if the mask design does not conform well to the contours of a patient's face. This can happen due to variations in facial structure or improper mask sizing. A good fit helps maximize positive pressure delivery while minimizing discomfort and air leakage, thereby improving the overall efficiency of the treatment.

Although factors like improper pressure settings and patient anxiety can influence the efficacy of NIV, they are less directly associated with mask leakage itself compared to the fit of the mask. Enhanced machine performance generally relates to the device's technical capabilities rather than the physical adherence of the mask to the patient's face. Thus, ensuring a good fit and proper adjustments is critical in minimizing leakage during NIV.