Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Esquinas Rodriguez, Antonio M, Papadakos, Peter J, Carron, Michele, Cosentini, Roberto, Chiumello, Davide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672531/
https://www.ncbi.nlm.nih.gov/pubmed/23680299
http://dx.doi.org/10.1186/cc11875
_version_ 1782272118736551936
author Esquinas Rodriguez, Antonio M
Papadakos, Peter J
Carron, Michele
Cosentini, Roberto
Chiumello, Davide
author_facet Esquinas Rodriguez, Antonio M
Papadakos, Peter J
Carron, Michele
Cosentini, Roberto
Chiumello, Davide
author_sort Esquinas Rodriguez, Antonio M
collection PubMed
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 CO(2 )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.
format Online
Article
Text
id pubmed-3672531
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
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 Crit Care 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 CO(2 )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
spellingShingle Review
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
title 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_short 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
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672531/
https://www.ncbi.nlm.nih.gov/pubmed/23680299
http://dx.doi.org/10.1186/cc11875
work_keys_str_mv AT esquinasrodriguezantoniom clinicalreviewhelmetandnoninvasivemechanicalventilationincriticallyillpatients
AT papadakospeterj clinicalreviewhelmetandnoninvasivemechanicalventilationincriticallyillpatients
AT carronmichele clinicalreviewhelmetandnoninvasivemechanicalventilationincriticallyillpatients
AT cosentiniroberto clinicalreviewhelmetandnoninvasivemechanicalventilationincriticallyillpatients
AT chiumellodavide clinicalreviewhelmetandnoninvasivemechanicalventilationincriticallyillpatients