Noninvasive continuous positive airway pressure ventilation using a new helmet interface: a case-control prospective pilot study

Tonnelier, Jean-Marie; Prat, Gwénaël; Nowak, Emmanuel; Goetghebeur, David; Renault, Anne; Boles, J.-M.; L’Her, Erwan

doi:10.1007/s00134-003-1925-6

Cited by 75 publications

(55 citation statements)

References 5 publications

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“…Bu nedenle helmetle yüz maskesini karşılaştıran çalışmalarda benzer basınç düzeyleri kullanılmıştır. (4,5,15) Navalesi ve ark.…”

Section: Discussionunclassified

“…Bu da cihazın önemli ölü boşluk volümü ile açıklanmak-tadır. (15) Olgularımız hafif ve orta derece hiperkapnik olgulardı. Hızlı düzelme beklenen ciddi hiperkapnik solunum yetmezliğinde, ilk tercih olarak yüz maskesi denenerek, intolerans durumunda helmete geçilebileceğini düşünmekteyiz.…”

Section: Discussionunclassified

“…(15) kardiyojenik pulmoner ödeme bağlı akut hipoksemik solunum yetmezliğinde ciddi solunumsal asidozlu ve hiperkapnik olgularda bile; yüksek ölü boşluk volümüne rağmen, helmet ile CPAP uygulanmasının yüz maskesi kadar etkin olduğunu ve alternatif olarak kullanılabileceğini bildirmiştir. Helmetle yan etki ve intolerans olmadan uzun süreli CPAP desteği sağlamışlardır.…”

Section: Discussionunclassified

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Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Mehtap¹,

Öztürk²,

Pehlivanoğlu³

et al. 2011

J Turk Anaesth Int Care

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ÖZETKOAH (Kronik Obstrüktif Akciğer Hastalığı) olan hastalarda akut atağa bağlı solunum yetmezliğinde standart tedaviye ilave noninvaziv pozitif basınçlı ventilasyon (NPBV) uygulaması; endotrakeal entübasyon ve mekanik ventilasyon gereksinimini ve ilişkili komplikasyonları azaltır. Helmet, şeffaf, yüze bası uygulamadığı için toleransı daha iyi olan ve NPBV uygulamasında kullanılan ventilatör-hasta bağlantı cihazıdır. Bu olgu sunumunda; KOAH akut atağına bağlı akut solunum yetmezliği tanısı ile yoğun bakım ünitesine alarak helmetle NPBV uyguladığımız üç olgu sunulmuştur. Olguların helmetle takipleri sırasında, oksijenizasyon ve kliniklerinde hızlı iyileşme gözlenirken, PCO 2 düzeylerinde daha yavaş seyreden düzelme gözlenmiştir. Bu olgular aracılığıyla, KOAH akut atağında NPBV uygulamasında; helmetle kan gazlarında düzelme sağlanarak başarılı sonuçlar alınabileceği gösterilmiş ve ideal ventilatör-hasta bağlantı seçimi irdelenmiştir.Anahtar kelimeler: Akut solunum yetmezliği, kronik obstrüktif akciğer hastalığı, noninvaziv pozitif basınçlı ventilasyon, helmet SUMMARY Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary DiseaseNoninvasive positive pressure ventilation (NPPV) in addition to the standard treatment in the respiratory failure due to acute exacerbation in the patients with chronic obstructive pulmonary disease (COPD) decreases the need for endotracheal intubation, mechanical ventilation and their related complications. Helmet is a transparent interface device which has better tolerance in that it does not exert pressure on the face and ensures the connection between the patient and the ventilator device in the NPPV application. Herein, we presented three cases whom we applied NPPV with helmet in the intensive care unit for acute respiratory failure because of acute exacerbation of COPD. During the follow-up of cases with Helmet, while the rapid improvement was observed in their oxygenation and clinical status, levels of PCO 2 improved relatively slowly. These cases have demonstrated that the successful results would be able to be obtained by normalizing blood gases via NPPV application with helmet in the acute exacerbation of COPD. Besides, the optimal interface selection is discussed in this study.

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“…Bu nedenle helmetle yüz maskesini karşılaştıran çalışmalarda benzer basınç düzeyleri kullanılmıştır. (4,5,15) Navalesi ve ark.…”

Section: Discussionunclassified

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Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Mehtap¹,

Öztürk²,

Pehlivanoğlu³

et al. 2011

J Turk Anaesth Int Care

View full text Add to dashboard Cite

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“…Moreover face masks are sometimes impossible to use due to peculiar patient's characteristics (e.g. in an edentulous patient, or in those wearing a beard); they are sometimes uncomfortable or poorly tolerated, possibly limiting the duration of application [13][14][15]. The correct application of face masks is therefore somehow difficult even in an Intensive Care Unit (ICU) or in the Emergency Room (ER), and it may be very problematic or ineffective in the pre-hospital setting.…”

Section: Introductionmentioning

confidence: 99%

Is helmet CPAP first line pre-hospital treatment of presumed severe acute pulmonary edema?

et al. 2008

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PURPOSE: Non invasive Continuous Positive Airway Pressure (CPAP) is effective in reducingintubation rate and mortality of patient with Acute Cardiogenic Pulmonary Edema (ACPE). We report our experience on pre-hospital application of CPAP by helmet as an adjunct to medical therapy or as a stand alone procedure in patient with presumed ACPE. METHODS: In pre-hospital treatment of 62 patients with presumed ACPE, CPAP was added to standard medical treatment while in another 59 patients, CPAP was used as a sole therapy . RESULTS: Helmet CPAP was feasible in all patients. No patient required pre-hospital intubation. In both groups, CPAP significantly improved oxygenation (SpO 2 went from 79 ± 12 % to 97 ± 3% and from 81 ± 13 % to 98 ± 3 %), reduced respiratory rate (from 26 ± 4 to 21 ± 3 bpm and from 30 ± 9 to 22 ± 8 bpm) and improved hemodynamics, with a more pronounced decrease in blood pressure in the group with medical treatment than in the one without it. In the two cohorts, four and five patients were respectively intubated in Emergency Department and eleven and nine eventually died. CONCLUSIONS:Helmet CPAP is feasible, efficient and safe in pre-hospital treatment of presumed ACPE. A significant improvement of physiological variables was observed also in the group treated with CPAP in absence of a drug therapy. We propose helmet CPAP as first line prehospital treatment of presumed severe ACPE.

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“…Continuous positive airway pressure delivered via helmets and nasal prongs may also be used because of skin issues. [12][13][14][15] However, the use of a helmet in adult volunteers resulted in rebreathing of carbon dioxide. 12 A full facial mask has the potential for greater redistribution of pressure because it covers the forehead and a larger area of the cheek/side of face than other masks.…”

mentioning

confidence: 99%

Pressure Ulcer Incidence in Patients Wearing Nasal-Oral Versus Full-Face Noninvasive Ventilation Masks

Schallom¹,

Cracchiolo²,

Falker³

et al. 2015

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Explain the importance of checking for pressure ulcers. 2. Identify areas of high risk for skin breakdown. 3. Enumerate advantages of wearing a full-face mask.To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue. " No CE test fee for AACN members.Background Device-related pressure ulcers from noninvasive ventilation masks alter skin integrity and cause patients discomfort. Objective To examine the incidence, location, and stage of pressure ulcers and patients' comfort with a nasal-oral mask compared with a full-face mask. Methods A before-after study of a convenience sample of patients with noninvasive ventilation orders in 5 intensive care units was conducted. Two groups of 100 patients each received either the nasal-oral mask or the full-face mask. Skin was assessed before the mask was applied and every 12 hours after that or upon mask removal. Comfort levels were assessed every 12 hours on a Likert scale of 1 to 5 (1, most comfortable). Results A pressure ulcer developed in 20% of patients in the nasal-oral mask group and 2% of patients in the full-face mask group (P < .001). Comfort scores were significantly lower (more comfortable) with the full-face mask (mean [SD], 1.9 [1.1]) than with the nasal-oral mask (mean [SD], 2.7 [1.2], P < .001). Neither mean hours worn nor percentage adherence differed significantly: 28.9 (SD, 27.2) hours and 92% for full-face mask and 25 (SD, 20.7) and 92% for nasal-oral mask. No patients who had a pressure ulcer develop with the nasal-oral mask had a pressure ulcer develop with the full-face mask. Conclusion The full-face mask resulted in significantly fewer pressure ulcers and was more comfortable for patients. The full-face mask is a reasonable alternative to traditional nasal-oral masks for patients receiving noninvasive ventilation. (American Journal of Critical Care. 2015;24:349-357) 1 The goal of noninvasive ventilation is to relieve symptoms associated with hypoventilation, exacerbation of chronic obstructive pulmonary disease, or impending respiratory failure; enhance gas exchange; maximize patients' comfort; and avoid intubation and invasive ventilation.1,2 Use of noninvasive ventilation is associated with device-related development of pressure ulcers under the mask. Published rates for the incidence of facial pressure ulcers associated with noninvasive ventilation masks range from 10% to 31%.3-5 Identification of device-related pressure ulcers, such as those associated with noninvasive ventilation masks, is becoming more common. [6][7][8] No research related to interventions to reduce the incidence or severity of pressure ulcers associated with noninvasive ventilation was found. However, several non-research-based recommendations were found in the literature. The Minnesota Hospital Association and recently the National Pressure Ulcer Advisory Panel (NPUAP) recommended consideration o...

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Noninvasive continuous positive airway pressure ventilation using a new helmet interface: a case-control prospective pilot study

Abstract: Despite a high dead-space volume (9-15 l), this new helmet interface is an efficient alternative to standard face mask during CPAP, even in cases of severe respiratory acidosis and hypercapnia. It allowed to provide long-duration CPAP, without any adverse events or clinical intolerance.

Cited by 75 publications

References 5 publications

Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Is helmet CPAP first line pre-hospital treatment of presumed severe acute pulmonary edema?

Pressure Ulcer Incidence in Patients Wearing Nasal-Oral Versus Full-Face Noninvasive Ventilation Masks

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