Choosing the Proper Interface for Positive Airway Pressure Therapy in Subjects With Acute Respiratory Failure

BaHammam, Ahmed S.; Singh, Tripat Deep; Gupta, Ravi; Pandi-Perumal, Seithikurippu R.

doi:10.4187/respcare.05787

Cited by 32 publications

(19 citation statements)

References 70 publications

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“…However, NIMV is often interrupted due to the patient intolerance, resulting in treatment failure. The reason may be related to the patient-ventilator interaction of NIMV [44]. The classic manner of interaction is the facial (also named oronasal) mask interface, which usually cause some complications, such as facial skin ulcer, eye irritation, aerophagia, etc., leading to patient intolerance.…”

Section: Discussionmentioning

confidence: 99%

The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis

et al. 2021

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Objective To compare the safety and effectiveness between helmet and face mask noninvasive mechanical ventilation (NIMV) in patients with acute respiratory failure (ARF). Methods English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wanfang Data, China Knowledge Resource Integrated Database and Chinese Biological Medicine Database. Randomized controlled trials (RCTs) comparing helmet and face mask NIMV for patients with ARF were searched. Meta-analysis was performed using Review manager 5.1.0. Results Twelve trials with a total of 569 patients were eligible. Our meta-analysis showed that, comparing with face mask, helmet could significantly decrease the incidences of intolerance [risk ratio (RR) 0.19; 95% confidence interval (CI) 0.09−0.39], facial skin ulcer (RR 0.19; 95% CI 0.08−0.43) and aerophagia (RR 0.15; 95% CI 0.06−0.37), reduce respiratory rate [mean difference (MD) -3.10; 95% CI -4.85 to -1.34], intubation rate (RR 0.39; 95% CI 0.26−0.59) and hospital mortality (RR 0.62; 95% CI 0.39−0.99) in patients with ARF, and improve oxygenation index in patients with hypoxemic ARF (MD 55.23; 95% CI 31.37−79.09). However, subgroupanalysis for hypercapnic ARF revealed that PaCO2 was significantly reduced in face mask group compared with helmet group (MD 5.34; 95% CI 3.41−7.27). Conclusion NIMV with helmet can improve the patient’s tolerance, reduce adverse events, increase oxygenation effect, and decrease intubation rate and hospital mortality comparing to face mask. However, the low number of patients from included studies may preclude strong conclusions. Large RCTs are still needed to provide more robust evidence.

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Section: Discussionmentioning

confidence: 99%

The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis

et al. 2021

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“…[12] Facial and ocular depositions were the main complaints previously reported with the use of facemask in addition to hindering eating and speech leading to interface displacement and less compliance. [13,14] The main problem noticed with HMP use was related to the inability of the patient to cooperate to maintain the interface in the mouth during the whole procedure.…”

Section: Discussionmentioning

confidence: 99%

Aerosol delivery aspects within a high-flow therapy system in COPD patients

et al. 2020

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There is a lack of information about the influence of patient interfaces like facemask or mouthpiece on the effective dose of aerosolized drugs while using high flow therapy in a clinical setting. These interfaces can improve pulmonary drug delivery over nasal cannula but patient preference and comfort should also be considered.The present work was to determine the effect of three different interfaces (nasal cannula, valved face mask, and mouthpiece) when combined with titrated oxygen flow on aerosol delivery in chronic obstructive pulmonary disease (COPD) patients hospitalised due to acute exacerbation.The variations between these interfaces were addressed in terms of change in lung function measurements pre-and post-inhalation, the delivered salbutamol dose, and patient tolerance to each interface.High flow nasal cannula was the most comfortable interface used. However, its pulmonary drug delivery was significantly lower than both the valved face mask and mouthpiece (p<0.05). Although drug delivery was different with the three tested interfaces, the lung function improvements were similar.

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“…NIV can either be applied in adult patients [ 9 ] or in pediatric care [ 12 ] through six types of interfaces [ 13 ]: nasal mask, oro-nasal mask (or face masks), nasal pillow mask, oral mask, full face mask, and helmets.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have already compared helmets to other interfaces [ 13 ], highlighting an increase in comfort, allowing free communication, easier drinking, and expectoration. Additionally, NIV with helmets seems to reduce by 33% the incidence of complications (e.g., skin lesions, air leakage, poor tolerance) related to NIV through other interfaces and improve relevant outcomes such as PaO 2 /FiO 2 compared to patients with facemasks [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Helmet-Noninvasive Ventilation for Hospitalized Critically Ill COVID-19 Patients: Has Vaccination and the New Variants Changed Evidence?

et al. 2022

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Noninvasive ventilation (NIV) is a technique for breathing support that significantly improves gas exchange and vital signs, reducing intubation and mortality rates. Helmets, unlike facemasks, allow for longer-term treatment and better ventilation, also being more cost-effective. As of today, we have found no reviews addressing this topic. This review aims to identify, map, and describe the characteristics of the use of noninvasive ventilation through helmet interface in critically ill COVID-19 adult patients hospitalized in acute care settings throughout the multiple moments that defined the COVID-19 pandemic. This scoping review will follow the methodology for scoping reviews proposed by JBI. A set of relevant electronic databases will be searched using terms such as COVID-19, helmet, and noninvasive ventilation. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher’s developed tool considering the review questions. Findings will be presented in tables and a narrative description that aligns with the review’s objective. This scoping review will consider any quantitative, qualitative, mixed-methods studies and systematic review designs for inclusion, focusing on the use of helmet on critically ill adult patients with COVID-19 hospitalized in acute care settings.

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Choosing the Proper Interface for Positive Airway Pressure Therapy in Subjects With Acute Respiratory Failure

Cited by 32 publications

References 70 publications

The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis

The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis

Aerosol delivery aspects within a high-flow therapy system in COPD patients

Helmet-Noninvasive Ventilation for Hospitalized Critically Ill COVID-19 Patients: Has Vaccination and the New Variants Changed Evidence?

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