Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients

Non-invasive mechanical ventilation (NIV) has proved to be an excellent technique in selected critically ill patients with different forms of acute respiratory failure. However, NIV can fail on account of the severity of the disease and technical problems, particularly at the interface. The helmet c...

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Main Authors:	Esquinas Rodriguez, Antonio M, Papadakos, Peter J, Carron, Michele, Cosentini, Roberto, Chiumello, Davide
Format:	Online
Language:	English
Published:	BioMed Central 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672531/

id	pubmed-3672531
recordtype	oai_dc
spelling	pubmed-36725312014-04-25 Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients Esquinas Rodriguez, Antonio M Papadakos, Peter J Carron, Michele Cosentini, Roberto Chiumello, Davide Review Non-invasive mechanical ventilation (NIV) has proved to be an excellent technique in selected critically ill patients with different forms of acute respiratory failure. However, NIV can fail on account of the severity of the disease and technical problems, particularly at the interface. The helmet could be an alternative interface compared to face mask to improve NIV success. We performed a clinical review to investigate the main physiological and clinical studies assessing the efficacy and related issues of NIV delivered with a helmet. A computerized search strategy of MEDLINE/PubMed (January 2000 to May 2012) and EMBASE (January 2000 to May 2012) was conducted limiting the search to retrospective, prospective, nonrandomized and randomized trials. We analyzed 152 studies from which 33 were selected, 12 physiological and 21 clinical (879 patients). The physiological studies showed that NIV with helmet could predispose to CO2 rebreathing and increase the patients' ventilator asynchrony. The main indications for NIV were acute cardiogenic pulmonary edema, hypoxemic acute respiratory failure (community-acquired pneumonia, postoperative and immunocompromised patients) and hypercapnic acute respiratory failure. In 9 of the 21 studies the helmet was compared to a face mask during either continous positive airway pressure or pressure support ventilation. In eight studies oxygenation was similar in the two groups, while the intubation rate was similar in four and lower in three studies for the helmet group compared to face mask group. The outcome was similar in six studies. The tolerance was better with the helmet in six of the studies. Although these data are limited, NIV delivered by helmet could be a safe alternative to the face mask in patients with acute respiratory failure. BioMed Central 2013 2013-04-25 /pmc/articles/PMC3672531/ /pubmed/23680299 http://dx.doi.org/10.1186/cc11875 Text en Copyright © 2013 BioMed Central Ltd
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Esquinas Rodriguez, Antonio M Papadakos, Peter J Carron, Michele Cosentini, Roberto Chiumello, Davide
spellingShingle	Esquinas Rodriguez, Antonio M Papadakos, Peter J Carron, Michele Cosentini, Roberto Chiumello, Davide Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients
author_facet	Esquinas Rodriguez, Antonio M Papadakos, Peter J Carron, Michele Cosentini, Roberto Chiumello, Davide
author_sort	Esquinas Rodriguez, Antonio M
title	Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients
title_short	Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients
title_full	Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients
title_fullStr	Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients
title_full_unstemmed	Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients
title_sort	clinical review: helmet and non-invasive mechanical ventilation in critically ill patients
description	Non-invasive mechanical ventilation (NIV) has proved to be an excellent technique in selected critically ill patients with different forms of acute respiratory failure. However, NIV can fail on account of the severity of the disease and technical problems, particularly at the interface. The helmet could be an alternative interface compared to face mask to improve NIV success. We performed a clinical review to investigate the main physiological and clinical studies assessing the efficacy and related issues of NIV delivered with a helmet. A computerized search strategy of MEDLINE/PubMed (January 2000 to May 2012) and EMBASE (January 2000 to May 2012) was conducted limiting the search to retrospective, prospective, nonrandomized and randomized trials. We analyzed 152 studies from which 33 were selected, 12 physiological and 21 clinical (879 patients). The physiological studies showed that NIV with helmet could predispose to CO2 rebreathing and increase the patients' ventilator asynchrony. The main indications for NIV were acute cardiogenic pulmonary edema, hypoxemic acute respiratory failure (community-acquired pneumonia, postoperative and immunocompromised patients) and hypercapnic acute respiratory failure. In 9 of the 21 studies the helmet was compared to a face mask during either continous positive airway pressure or pressure support ventilation. In eight studies oxygenation was similar in the two groups, while the intubation rate was similar in four and lower in three studies for the helmet group compared to face mask group. The outcome was similar in six studies. The tolerance was better with the helmet in six of the studies. Although these data are limited, NIV delivered by helmet could be a safe alternative to the face mask in patients with acute respiratory failure.
publisher	BioMed Central
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672531/
_version_	1611983633663393792

Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients

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