Noninvasive positive pressure ventilation delivered by helmet vs. standard face mask. 2003

Davide Chiumello, and Paolo Pelosi, and Eleonora Carlesso, and Paolo Severgnini, and Michele Aspesi, and Chiara Gamberoni, and Massimo Antonelli, and Giorgio Conti, and Maurizio Chiaranda, and Luciano Gattinoni
Istituto di Anestesia e Rianimazione, Ospedale Maggiore Policlinico-IRCCS, Universita' degli Studi di Milano, via Francesco Sforza 35, 20122 Milan, Italy. chiumello@libero.it

OBJECTIVE This bench and human study compared large and small helmets with face mask (FM) for delivery of noninvasive positive pressure ventilation. METHODS 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. METHODS 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 CPAPHF 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 CPAPVENT 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 CPAPVENT and PSV, FM was more efficient than helmets

UI MeSH Term Description Entries
D008397 Masks Devices that cover the nose and mouth to maintain aseptic conditions often for the prevention of the spread of infections (e.g. COVID19) or to administer inhaled anesthetics or other gases. Mask
D008953 Models, Anatomic Three-dimensional representation to show anatomic structures. Models may be used in place of intact animals or organisms for teaching, practice, and study. Anatomic Models,Models, Surgical,Moulages,Models, Anatomical,Anatomic Model,Anatomical Model,Anatomical Models,Model, Anatomic,Model, Anatomical,Model, Surgical,Moulage,Surgical Model,Surgical Models
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D012131 Respiratory Insufficiency Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed) Acute Hypercapnic Respiratory Failure,Acute Hypoxemic Respiratory Failure,Hypercapnic Acute Respiratory Failure,Hypercapnic Respiratory Failure,Hypoxemic Acute Respiratory Failure,Hypoxemic Respiratory Failure,Respiratory Depression,Respiratory Failure,Ventilatory Depression,Depressions, Ventilatory,Failure, Hypercapnic Respiratory,Failure, Hypoxemic Respiratory,Failure, Respiratory,Hypercapnic Respiratory Failures,Hypoxemic Respiratory Failures,Respiratory Failure, Hypercapnic,Respiratory Failure, Hypoxemic,Respiratory Failures
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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