Background/aim: Noninvasive mechanical ventilation (NIMV) is an approach to prevent complications in acute respiratory failure. In this study we aimed to compare the efficacy of a full face mask and a helmet in chronic obstructive pulmonary disease (COPD).Materials and methods: Fifty patients were divided randomly into 2 groups as full face mask (Group F) and helmet (Group H). Demographic data, forced expiratory volume at 1 s (FEV1), additional disease, hemodynamic parameters, respiratory rate, APACHE II score, peripheral O 2 saturation (SpO 2 ), arterial blood gases (ABG), patient tolerance scale (PTS) score, and fraction of inspired oxygen (FiO 2 ) were recorded. Parameters were recorded as follows: 20 min before the NIMV; every 30 min of NIMV until 120 min; 30 min, 24 h, and 48 h after NIMV; and prior to intensive care unit discharge. Results:The SpO 2 , PTS, ABG, complication rate, and APACHE II scores were not different between the groups (P > 0.05). The decrease in PaCO 2 was statistically significant at 60 min in Group F (P < 0.05), and there was no statistical difference in Group H (P < 0.05) according to initial PaCO 2 values. Conclusion:Both masks are efficient in improving the patients' outcome in COPD, but the decrease in PaCO 2 in the helmet group was slower than in the full face mask group.

ÖZETKOAH (Kronik Obstrüktif Akciğer Hastalığı) olan hastalarda akut atağa bağlı solunum yetmezliğinde standart tedaviye ilave noninvaziv pozitif basınçlı ventilasyon (NPBV) uygulaması; endotrakeal entübasyon ve mekanik ventilasyon gereksinimini ve ilişkili komplikasyonları azaltır. Helmet, şeffaf, yüze bası uygulamadığı için toleransı daha iyi olan ve NPBV uygulamasında kullanılan ventilatör-hasta bağlantı cihazıdır. Bu olgu sunumunda; KOAH akut atağına bağlı akut solunum yetmezliği tanısı ile yoğun bakım ünitesine alarak helmetle NPBV uyguladığımız üç olgu sunulmuştur. Olguların helmetle takipleri sırasında, oksijenizasyon ve kliniklerinde hızlı iyileşme gözlenirken, PCO 2 düzeylerinde daha yavaş seyreden düzelme gözlenmiştir. Bu olgular aracılığıyla, KOAH akut atağında NPBV uygulamasında; helmetle kan gazlarında düzelme sağlanarak başarılı sonuçlar alınabileceği gösterilmiş ve ideal ventilatör-hasta bağlantı seçimi irdelenmiştir.Anahtar kelimeler: Akut solunum yetmezliği, kronik obstrüktif akciğer hastalığı, noninvaziv pozitif basınçlı ventilasyon, helmet SUMMARY Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary DiseaseNoninvasive positive pressure ventilation (NPPV) in addition to the standard treatment in the respiratory failure due to acute exacerbation in the patients with chronic obstructive pulmonary disease (COPD) decreases the need for endotracheal intubation, mechanical ventilation and their related complications. Helmet is a transparent interface device which has better tolerance in that it does not exert pressure on the face and ensures the connection between the patient and the ventilator device in the NPPV application. Herein, we presented three cases whom we applied NPPV with helmet in the intensive care unit for acute respiratory failure because of acute exacerbation of COPD. During the follow-up of cases with Helmet, while the rapid improvement was observed in their oxygenation and clinical status, levels of PCO 2 improved relatively slowly. These cases have demonstrated that the successful results would be able to be obtained by normalizing blood gases via NPPV application with helmet in the acute exacerbation of COPD. Besides, the optimal interface selection is discussed in this study.