A NOVEL tube and inhaler adaptor for non-invasive ventilation (TIA-NIV) significantly reduces air leaks by 71% and improves patient comfort, according to a quasi-experimental study of 196 ICU patients.
Non-invasive ventilation (NIV) is a cornerstone treatment for respiratory failure, but concurrent needs for enteric feeding tubes and aerosol therapies often compromise mask seals, leading to air leaks and reduced efficacy. The TIA-NIV, an integrated adaptor compatible with oro-nasal masks, addresses these challenges by enabling simultaneous tube placement and medication delivery while maintaining ventilator integrity. This innovation could transform care for critically ill patients requiring multifaceted respiratory support.
The study compared conventional NIV to TIA-NIV in ICU patients over 16 months. With the adaptor, mean air leaks plummeted from 32.5% (±12.5%) to 9.2% (±7.7%, p<0.001), while 84.9% of patients reported improved comfort. The device’s design – featuring a universal 22mm port for enteric tubes (≥12Fr) and integrated MDI chamber – prevented interface displacement common in traditional setups. Secondary benefits included uninterrupted aerosol delivery (aligning with in vitro findings on nebuliser positioning efficacy) and secure post-extubation NIV support, even with airway exchange catheters in situ.
These results suggest TIA-NIV could standardise care pathways for NIV patients requiring enteral nutrition or bronchodilators, particularly in COPD and cardiogenic pulmonary oedema cases. Clinicians should consider early adoption in ICUs to reduce complications from repeated mask adjustments. Future research must validate these findings through randomised trials and explore paediatric applications (currently limited by tube-size compatibility). Manufacturers should prioritise expanding port calibres and developing smaller adaptors for neonatal use. Health systems should assess cost-benefit ratios against current workarounds, given TIA-NIV’s potential to shorten ICU stays through enhanced therapy delivery and reduced air leak-related readmissions.
Reference
Quintero OI et al. Novel tube and inhaler adaptor for non-invasive ventilation: from design to clinical impact. BMJ Innovations. 2025;DOI:10.1136/bmjinnov-2024-001242.
