Intensive Care Medicine

, Volume 33, Issue 1, pp 74–81

Non-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask

  • Paolo Navalesi
  • Roberta Costa
  • Piero Ceriana
  • Annalisa Carlucci
  • George Prinianakis
  • Massimo Antonelli
  • Giorgio Conti
  • Stefano Nava
Original

DOI: 10.1007/s00134-006-0391-3

Cite this article as:
Navalesi, P., Costa, R., Ceriana, P. et al. Intensive Care Med (2007) 33: 74. doi:10.1007/s00134-006-0391-3

Abstract

Rationale

The helmet is a new interface with the potential of increasing the success rate of non-invasive ventilation by improving tolerance.

Objectives

To perform a physiological comparison between the helmet and the conventional facial mask in delivering non-invasive ventilation in hypercapnic patients with chronic obstructive pulmonary disease.

Methods

Prospective, controlled, randomized study with cross-over design. In 10 patients we evaluated gas exchange, inspiratory effort, patient–ventilator synchrony and patient tolerance after 30 min of non-invasive ventilation delivered either by helmet or facial mask; both trials were preceded by periods of spontaneous unassisted breathing.

Measurements

Arterial blood gases, inspiratory effort, duration of diaphragm contraction and ventilator assistance, effort-to-support delays (at the beginning and at the end of inspiration), number of ineffective efforts, and patient comfort.

Main results

Non-invasive ventilation improved gas exchange (p< 0.05) and inspiratory effort (p< 0.01) with both interfaces. The helmet, however, was less efficient than the mask in reducing inspiratory effort (p< 0.05) and worsened the patient–ventilator synchrony, as indicated by the longer delays to trigger on (p< 0.05) and cycle off (p< 0.05) the mechanical assistance and by the number of ineffective efforts (p< 0.005). Patient comfort was no different with the two interfaces.

Conclusions

Helmet and facial mask were equally tolerated and both were effective in ameliorating gas exchange and decreasing inspiratory effort. The helmet, however, was less efficient in decreasing inspiratory effort and worsened the patient–ventilator interaction.

Keywords

Non-invasive positive pressure ventilation Respiratory insufficiency Chronic obstructive pulmonary disease Patient–ventilator interaction Controlled clinical trial 

Supplementary material

134_2006_391_MOESM1_ESM.doc (1.6 mb)
Electronic Supplementary Material (DOC 1,6M)

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Paolo Navalesi
    • 1
  • Roberta Costa
    • 2
  • Piero Ceriana
    • 1
  • Annalisa Carlucci
    • 1
  • George Prinianakis
    • 3
  • Massimo Antonelli
    • 2
  • Giorgio Conti
    • 2
  • Stefano Nava
    • 1
  1. 1.Pneumologia Riabilitativa e Terapia Intensiva RespiratoriaFondazione S. Maugeri IRCCSPaviaItaly
  2. 2.Istituto di Anestesia e RianimazioneUniversità Cattolica del Sacro CuoreRomaItaly
  3. 3.Intensive Care Medicine DepartmentUniversity Hospital of HeraklionHeraklionGreece