Non-invasive ventilation delivered by conventional interfaces and helmet in the emergency department.

Paolo Pelosi, Paolo Severgnini, Michele Aspesi, Chiara Gamberoni, Davide Chiumello, Cecilia Fachinetti, Lorenzo Introzzi, Massimo Antonelli, Maurizio Chiaranda

Research output: Contribution to journalArticle

Abstract

Non-invasive positive pressure ventilation is increasingly used as a first-line treatment for respiratory failure. Non-invasive positive pressure ventilation can reduce the complications of endotracheal intubation such as barotrauma, nosocomial infections and the need for sedation. Non-invasive positive pressure ventilation has been shown to reduce the rate of endotracheal intubation in acute cardiogenic pulmonary oedema (27%), in chronic obstructive pulmonary disease (21%), and in acute respiratory failure (17%). Non-invasive positive pressure ventilation can be successfully delivered in the emergency department or in the general ward. However, the criteria for interrupting non-invasive positive pressure ventilation must be stricter (i.e. failure to improve gas exchange within 30 min) than in the general ward. One of the main reasons for the failure of non-invasive positive pressure ventilation lies in the technical problems caused by the face mask. We recently developed a new interface, the 'helmet', to deliver non-invasive positive pressure ventilation. When using the helmet instead of a face mask an increase of 10 cm H(2)O of pressure support and a fast pressurization rate are recommended. In a lung model and in healthy individuals the helmet reduced inspiratory effort. In hypoxemic patients the helmet reduced the intubation rate and the incidence of face mask-related complications. We believe that the helmet can extend the application of non-invasive positive pressure ventilation in different categories of patients with respiratory failure.

Original languageEnglish
Pages (from-to)79-86
Number of pages8
JournalEuropean Journal of Emergency Medicine
Volume10
Issue number2
Publication statusPublished - Jun 2003

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ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Pelosi, P., Severgnini, P., Aspesi, M., Gamberoni, C., Chiumello, D., Fachinetti, C., Introzzi, L., Antonelli, M., & Chiaranda, M. (2003). Non-invasive ventilation delivered by conventional interfaces and helmet in the emergency department. European Journal of Emergency Medicine, 10(2), 79-86.