Table 2 Risk factors for the development of interface-related pressure ulcers in NIV
General risks
 Sensory impairment
 Acute illness
 Chronic illness
 Hypoxia or very low blood pressure
 Extremes of age
 Low level of consciousness
 Psychological status
 Vascular disease
 Chronic skin condition
 History of previous pressure damage
 Medication (e.g. analgesia, chronic steroid therapy, cytotoxins)
Extrinsic factors
 Closely fitting headgear and over-tightened straps
 Poorly fitted masks and headgear (i.e. too big or too small, too old or wrong style)
 Mechanical forces: pressure, shear or friction from the interface
 Allergy to the cushion
Other factors
 Skin damage: dry, flaky, excoriated, discoloured or macerated skin
 Shape and size of nose/face
 Time period that mask pressure is applied
 Inability to self-manage the mask