Noninvasive positive pressure ventilation delivered by helmet vs. standard face mask

Davide Chiumello, Paolo Pelosi, Eleonora Carlesso, Paolo Severgnini, Michele Aspesi, Chiara Gamberoni, Massimo Antonelli, Giorgio Conti, Maurizio Chiaranda, Luciano Gattinoni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This bench and human study compared large and small helmets with face mask (FM) for delivery of noninvasive positive pressure ventilation. Design: A lung simulator was employed, and the human study involved six healthy subjects. We evaluated a continuous high-flow (CPAPHF), low flow (CPAPLF), ventilator (CPAPVENT) CPAP, and pressure support ventilation (PSV 10 and 20 cmH2O). In the human study we used CPAPHF, CPAPVENT, and PSV 5 cmH2O. PEEP was 5 cmH2O. Measurements: In the bench study during CPAP we measured the negative airway pressure time product (areaCPAP), i.e., the area of airway pressure (Paw) under PEEP and during PSV the pressure airway time product (areaPSV), i.e., the area of Paw from onset to end of inspiratory flow. In the human study we measured the breathing pattern and work of breathing (WOB). Results: In the bench study during CPAPLF the helmets had a lower areaCPAP than the FM, while during CPAP HF the three interfaces had similar areaCPAP. Using CPAPVENT and PSV the FM reduced areaCPAP and increased areaPSV compared to helmets. At 20 cmH2O of PSV using helmets areaPSV was similar to that obtained at 10 cmH2O of PSV using the FM. In human study using CPAPHF and CPAP VENT the tree interfaces had similar effects on breathing pattern and WOB, while using PSV the FM reduced WOB more than helmets. Conclusions: During CPAPLF helmets were more efficient than FM, while during CPAPHF the three interfaces were comparable. Using CPAP VENT and PSV, FM was more efficient than helmets.

Original languageEnglish
Pages (from-to)1671-1679
Number of pages9
JournalIntensive Care Medicine
Volume29
Issue number10
DOIs
Publication statusPublished - Oct 2003

Keywords

  • Comfort of breathing
  • Facial mask
  • Helmet
  • Interfaces
  • Noninvasive ventilation
  • Work of breathing

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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