The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

Coppadoro, Andrea; Zago, Elisabetta; Pavan, Fabio; Bellani, Giacomo

doi:10.1186/s13054-021-03746-8

Cited by 31 publications

(25 citation statements)

References 109 publications

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“…Noninvasive ventilatory support, based on free-flow continuous positive airway pressure (CPAP) delivered by helmet or face mask or high-flow nasal oxygen (HFNO), is increasingly used to treat patients with acute respiratory failure (1). During the recent Coronavirus-2019 (COVID-19) pandemic, the use of free-flow system massively spread also outside the intensive care units (2)(3)(4)(5). The main advantage of free-flow systems is that an active mechanical ventilator is not required; a flow generator connected to the oxygen pipe or tank can feed a helmet or a face mask to provide CPAP through a positive end-expiratory pressure (PEEP) valve (6), or to nasal cannulas to provide HFNO (7).…”

Section: Background and Rationalementioning

confidence: 99%

A novel Venturi system to generate high flow with titratable FiO2

Coppadoro

Bellani

2021

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Venturi-based flow generators are commonly used for noninvasive continuous positive airway pressure (CPAP) of high-flow nasal oxygen (HFNO). The system is simple and allows to increase the total flow while decreasing the FiO2 starting from a single oxygen source. In this report we describe the characteristics and performance of a novel Venturi system (EasyVEE, Levate, BG, Italy), which allows to vary the size of the port through which ambient air is entrained, hence allowing a continuous modulation of FiO2. The system allowed to modify FiO2 continuously between 35% and 80% and, consequently, a 1.5- to 4.5-fold increase of the total flow rate. A minimal decrease in entrainment performance was observed for positive end-expiratory pressure levels above 12.5 cmH2O. EasyVEE system appears to be a simple, flexible, and reliable solution to generate continuous flow for noninvasive respiratory support interfaces.

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Section: Background and Rationalementioning

confidence: 99%

A novel Venturi system to generate high flow with titratable FiO2

Coppadoro

Bellani

2021

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“…The use of heated humidified air during helmet NIV therapy mimics the normal spontaneous breathing processes, which is essential to prevent oral and nasal mucosal dryness (Coppadoro et al, 2021). However, in Dimech (2012), patients likened the environment inside the heated humidified air employed helmet as 'sitting in a sauna with no breeze or anything on the face', which is rather oppressive.…”

Section: Humidity-temperaturementioning

confidence: 99%

“…Patient comfort is crucial during non-invasive ventilation (NIV) to decrease possible complications leading to endotracheal intubation (Coppadoro et al, 2021). Comfort is a core component in patient-centred care (PCC); a contemporary strategy aims to heighten health care quality.…”

Section: Introductionmentioning

confidence: 99%

“…Congruous with the PCC concept, the number of comparative studies between NIV interfaces is escalating, inquiring about the most effective and superior interface (Grieco et al, 2020). As a result, Helmet NIV turns to be one of the preferred latest NIV interfaces, considering the abundance of positive outcomes: improved oxygenation (Pisani et al, 2015), reduced work of breathing (WOB), more comfort and better tolerance (Coppadoro et al, 2021;Pisani et al, 2015;Tiru et al, 2017), ease of oral intake and reduce the rate for endotracheal intubation (Grieco et al, 2021), which collectively reduce mortality rate and reduce the length of hospital stay.…”

Section: Introductionmentioning

confidence: 99%

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Helmet Non-invasive Ventilation Therapy: Measurement of comfort behaviour

Majid

Nordin

Osran

et al. 2021

E-BPJ

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Comfort is integral towards tolerance in helmet non-invasive ventilation (NIV) therapy among acute respiratory failure (ARF) patients. This study aims to measure the patients’ comfort behaviour level after completion of helmet NIV therapy. It is a quantitative, descriptive, observational study involving 67 ARF patients. Kolcaba's Comfort Behavioural Checklist (CBC) was used, with the highest score of 120. The mean CBC score was 88.54, SD 7.35, indicating moderate comfort level; for Acute Pulmonary Oedema (APO) and non- APO, patients were 89.88, SD 7.25, and 87.08, SD 7.80 respectively. This reflects genuine patients' response towards therapy which is significant for future improvement. Keywords: Helmet Continuous Positive Airway Pressure; CPAP; Kolcaba’s Behavioural Checklist; Acute Respiratory Failure eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i18.3082

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“…The helmet is broadly used in southern Europe and particularly in Italy, mainly for the treatment of hypoxemic respiratory failure and acute cardiogenic pulmonary edema (7). To perform helmet-CPAP (H-CPAP), a continuous flow generator is used to provide a fresh gas flow (8). This gas flow is delivered inside the helmet and generates a positive end-expiratory pressure (PEEP) as it flows through an expiratory valve (9).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Filters on CPAP Delivery by Helmet

et al. 2022

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Background: When helmet continuous positive airway pressure (H-CPAP) is performed using a Venturi system, filters are frequently interposed in the respiratory circuit to reduce noise within the helmet. The effect of the interposition of these filters on delivered fresh gas flow and the resulting inspired fraction of oxygen (FiO 2 ) is currently unknown. Methods:In a bench study, two different Venturi systems (Whisperflow and Harol) were used to generate three different gas flow/FiO 2 couples (80 L/min-FiO 2 0.6; 100 L/min-FiO 2 0.5; 120 L/min-FiO 2 0.4). Different combinations of filters were applied at the flow generator input line and/or at the helmet inlet port. Two types of filters were used for this purpose: a heat and moister exchanger filter and an electrostatic filter. The setup without filters was used as Baseline. Gas flow and FiO 2 were measured for each setup.Results: Compared to Baseline, the interposition of filters reduced the gas flow between 1 and 13% (p<0.01). The application of a filter at the Venturi system or at the Helmet generated a comparable flow reduction (-3 ± 2% vs. -4 ± 2%, p=0.12), while a greater flow reduction (-7 ± 4%) was observed when filters were applied at both sites (p<0.001). An increase in FiO 2 up to 5% was observed with filters applied. A strong inverse linear relationship (p<0.001) was observed between the resulting gas flow and FiO 2 . Conclusions:The use of filters during H-CPAP reduces the flow delivered to the helmet and, consequently, modifies FiO 2 . If filters are applied, an adequate gas flow should be administered to guarantee a constant CPAP during the entire respiratory cycle and avoid CO 2 rebreathing.Moreover, it might be important to measure the effective FiO 2 delivered to the patient to guarantee a precise assessment of oxygenation.

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The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

Cited by 31 publications

References 109 publications

A novel Venturi system to generate high flow with titratable FiO2

A novel Venturi system to generate high flow with titratable FiO2

Helmet Non-invasive Ventilation Therapy: Measurement of comfort behaviour

The Effect of Filters on CPAP Delivery by Helmet

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