JOURNAL CLUB: Helmet noninvasive support in hypoxemic respiratory failure
By: Marcelo Alcantara, Médico - 06/21/2022 19:03
Recently, there has been renewed interest in using noninvasive ventilation (NIV) and continuous positive airway pressure (CPAP) delivered through the helmet interface.
This interface has many advantages over other types:
-Better comfort favoring prolonged continuous use
-Possibility of applying higher PEEP levels
-Avoidance of air leaks and ambient and personal contamination through patient droplets.
-Potential of mitigating patient-self inflicted lung injury (P-SILI)
-Reduction of transpulmonary driving pressure
In this opinion paper, experts in the field, Drs Domenico L Grieco and Massimo Antonelli fromFondazione Policlinico Universitario A. Gemelli, Rome, Italy and Dr Bhakti K Patel, from Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, IL, USA comments on physiological, clinical, pragmatical and potential aspects of helmet-based ventilatory support.
Two main possibilities for using it exist: HELMET-NIV and HELMET-CPAP, as shown in the figure:
No studies have compared them face to face.
However, they make interesting suggestions on how to use it in both setups.
Find the full paper in the link below.
In Brazil, a new helmet-CPAP interface has been developed in Ceará state, changing how COVID-19 patients were treated during the pandemic.
Find the ELMO experience (ELMO means "A War Helmet" in Portuguese)
Check the feasibility paper and the dedicated site below
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