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Intensive Care Medicine

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01.04.2013 | Physiological and Technical Notes

Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation

verfasst von: C. Olivieri, R. Costa, G. Spinazzola, G. Ferrone, F. Longhini, G. Cammarota, G. Conti, P. Navalesi

Erschienen in: Intensive Care Medicine | Ausgabe 4/2013

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Abstract

Objective

To evaluate the performance of a new helmet (NH) recently introduced into clinical use relative to that of the standard helmet (SH) in terms of delivering non-invasive continuous positive airway pressure (nCPAP) and pressure support ventilation (nPSV).

Design

This was a bench study using a mannequin connected to an active lung simulator. The SH was fastened to the mannequin by armpit braces, which are not needed to secure the NH.

Measurements

The inspiratory and expiratory variations in nCPAP delivered with two different simulated efforts (Pmus), were determined relative to the preset CPAP level. nPSV was applied at two simulated respiratory rates (RR) and two cycling-off flow thresholds. We measured inspiratory trigger delay (Delay_trinsp), expiratory trigger delay (Delay_trexp), time of synchrony (Time_sync), trigger pressure drop (ΔP _trigger), airway pressure–time product during the triggering phase (PTPt), the initial 200 ms from the onset of the ventilator pressurization (PTP₂₀₀), and the initial 300 and 500 ms from the onset of the simulated effort; this two latter parameters were expressed as the percentage of the area of ideal pressurization (PTP_300-index and PTP_500-index, respectively).

Results

In nCPAP, at both Pmus, the differences between the two interfaces at both Pmus were small and clinically irrelevant. In nPSV, regardless of the setting, NH resulted in significantly smaller trigger delays, ΔP _trigger, and PTPt. Time_sync, PTP₂₀₀, PTP_300-index, and PTP_500-index were also significantly higher with the NH compared to the SH, irrespective of the setting.

Conclusions

Compared to the SH, the NH is equally effective in delivering nCPAP and more effective in delivering nPSV, and it is used to avoid the need for armpit braces.

Nur mit Berechtigung zugänglich

Navalesi P, Fanfulla F, Frigerio P, Gregoretti C, Nava S (2000) Physiologic evaluation of non-invasive mechanical ventilation delivered with three types of masks in patients with chronic hypercapnic respiratory failure. Crit Care Med 28:1785–1790PubMedCrossRef

Fraticelli AT, Lellouche F, l’Her E, Taillé S, Mancebo J, Brochard L (2009) Physiological effects of different interfaces during non-invasive ventilation for acute respiratory failure. Crit Care Med 37:939–945PubMedCrossRef

Vargas F, Thille A, Lyazidi A, Campo FR, Brochard L (2009) Helmet with specific settings versus facemask for non-invasive ventilation. Crit Care Med 37:1921–1928PubMedCrossRef

L’Her E, Deye N, Lellouche F, Taille S, Demoule A, Fraticelli A, Mancebo J, Brochard L (2005) Physiologic effects of non-invasive ventilation during acute lung injury. Am J Respir Crit Care Med 172:1112–1118PubMedCrossRef

Navalesi P, Costa R, Ceriana P, Carlucci A, Prinianakis G, Antonelli M, Conti G, Nava S (2007) Non-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask. Intensive Care Med 33:74–81PubMedCrossRef

Carlucci A, Richard JC, Wysocki M, Lepage E, Brochard L, the SRLF Collaborative Group on Mechanical Ventilation (2001) Non-invasive versus conventional mechanical ventilation. An epidemiologic survey. Am J Respir Crit Care Med 163:874–880PubMed

Gregoretti C, Confalonieri M, Navalesi P, Squadrone V, Frigerio P, Beltrame F, Carbone G, Conti G, Gamna F, Nava F, Calderini E, Skrobik Y, Antonelli M (2002) Evaluation of patient skin breakdown and comfort with a new face mask for non-invasive ventilation: a multi-center study. Intensive Care Med 28:278–284PubMedCrossRef

Antonelli M, Conti G, Pelosi P, Gregoretti C, Pennisi MA, Costa R, Severgnini P, Chiaranda M, Proietti R (2002) New treatment of acute hypoxemic respiratory failure: non-invasive mechanical ventilation delivered by helmet; a pilot trial study. Crit Care Med 30:602–608PubMedCrossRef

Antonelli M, Pennisi MA, Pelosi P, Gregoretti C, Squadrone V, Rocco M, Cecchini L, Chiumello D, Severgnini P, Proietti R, Navalesi P, Conti G (2004) Non-invasive positive pressure ventilation ventilation using an helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology 100:16–24PubMedCrossRef

10.

Rocco M, Dell’Utri D, Morelli A, Spadetta G, Conti G, Antonelli M, Pietropaoli P (2004) Non-invasive ventilation by helmet or face mask in immunocompromised patients: a case control study. Chest 126:1508–1515PubMedCrossRef

11.

Antonaglia V, Ferluga M, Molino R, Lucangelo U, Peratoner A, Roman-Pognuz E, De Simoni L, Zin WA (2011) Comparison of non-invasive ventilation by sequential use of mask and helmet versus mask in acute exacerbation of chronic obstructive pulmonary disease: a preliminary study. Respiration 82:148–154PubMedCrossRef

12.

Lucchini A, Valsecchi D, Elli S, Doni V, Corsaro P, Tundo P, Re R, Foti G, Manici M (2010) The comfort of patients ventilated with the Helmet Bundle (in Italian). Assist Inferm Ric 29:174–183 ReviewPubMed

13.

Costa R, Navalesi P, Spinazzola G, Rossi M, Cavaliere F, Antonelli M, Proietti R, Conti G (2008) Comparative evaluation of different helmets on patient–ventilator interaction during non-invasive ventilation. Intensive Care Med 34:1102–1108PubMedCrossRef

14.

Costa R, Navalesi P, Spinazzola G, Ferrone G, Pellegrini A, Cavaliere F, Proietti R, Antonelli M, Conti G (2010) Influence of ventilator settings on patient–ventilator synchrony during pressure support ventilation with different interfaces. Intensive Care Med 36:1363–1370PubMedCrossRef

15.

Moerer O, Fischer S, Hartelt M, Kuvaki B, Quintel M, Neumann P (2006) Influence of two different interfaces for non-invasive ventilation compared to invasive ventilation on the mechanical properties and performance of a respiratory system: a lung model study. Chest 129:1424–1431PubMedCrossRef

16.

Olivieri C, Costa R, Conti G, Navalesi P (2012) Bench studies evaluating devices for non-invasive ventilation: critical analysis and future perspectives. Intensive Care Med 38:160–167PubMedCrossRef

17.

Tassaux D, Strasser S, Fonseca S, Dalmas E, Jolliet P (2002) Comparative bench study of triggering, pressurization, and cycling between the home ventilator VPAP II and three ICU ventilators. Intensive Care Med 28:1254–1261PubMedCrossRef

18.

Ferrari G, Olliveri F, De Filippi G, Milan A, Aprà F, Boccuzzi A, Converso M, Navalesi P (2007) Non-invasive positive airway pressure and risk of myocardial infarction in acute cardiogenic pulmonary edema: continuous positive airway pressure vs. non-invasive positive pressure ventilation. Chest 132:1804–1809PubMedCrossRef

19.

Cammarota G, Vaschetto R, Turucz E, Dellapiazza F, Colombo D, Blando C, Della Corte F, Maggiore SM, Navalesi P (2011) Influence of lung collapse distribution on the physiologic response to recruitment maneuvers during non-invasive continuous positive airway pressure. Intensive Care Med 37:1095–1102PubMedCrossRef

20.

Patroniti N, Foti G, Manfio A, Coppo A, Bellani G, Pesenti A (2003) Head helmet versus face mask for non-invasive continuous positive airway pressure: a physiological study. Intensive Care Med 29:1680–1687PubMedCrossRef

Titel: Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation
verfasst von: C. Olivieri
R. Costa
G. Spinazzola
G. Ferrone
F. Longhini
G. Cammarota
G. Conti
P. Navalesi
Publikationsdatum: 01.04.2013
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 4/2013
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2765-z

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Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation