, Volume 29, Issue 10, pp 1680-1687
Date: 28 Aug 2003

Head helmet versus face mask for non-invasive continuous positive airway pressure: a physiological study

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Abstract

Objective

To assess selected physiological effects of non-invasive continuous positive airway pressure delivered by head helmet (CPAPH), a special interface device designed to completely contain the head of the patient, compared to face mask (CPAPM).

Design

Randomized physiological study.

Setting

University research laboratory.

Patients

Eight healthy volunteers.

Intervention

Continuous positive airway pressure delivered by face mask and CPAPH in random order. Three gas flow rates (20-30-40 l/min and 30-45-60 l/min, respectively, for CPAPM and CPAPH) and four CPAP levels (0-5-10-15 cmH2O) were employed in a randomized sequence.

Measurements and results

In each patient we monitored airway pressure, esophageal pressure, expiratory flow, and inspiratory and expiratory CO2 concentration. End-expiratory lung volume changes from CPAP 0 were measured by inductance plethysmography. The application of increased levels of CPAP resulted in a significant increase in end-expiratory lung volume, similar for CPAPH and CPAPM. Inspiratory changes of airway pressure were comparable for the two CPAP modes. Inspiratory CO2 concentration was higher during CPAPH (significantly decreased at increased gas flow rates), compared to CPAPM.

Conclusions

Continuous positive airway pressure delivered by head helmet is as effective as CPAPM in increasing end-expiratory lung volume and in compensating for airway pressure changes without the need of a reservoir bag. Higher gas flow rates are necessary to maintain a relatively low inspiratory CO2 concentration.