Cost Analysis of Noninvasive Helmet Ventilation Compared with Use of Noninvasive Face Mask in ARDS

Abstract

Intensive care unit (ICU) costs have doubled since 2000, totalling 108 billion dollars per year. Acute respiratory distress syndrome (ARDS) has a prevalence of 10.4% and a 28-day mortality of 34.8%. Noninvasive ventilation (NIV) is used in up to 30% of cases. A recent randomized controlled trial by Patel et al. (2016) showed lower intubation rates and 90-day mortality when comparing helmet to face mask NIV in ARDS. The population in the Patel et al. trial was used for cost analysis in this study. Projections of cost savings showed a decrease in ICU costs by $2527 and hospital costs by $3103 per patient, along with a 43.3% absolute reduction in intubation rates. Sensitivity analysis showed consistent cost reductions. Projected annual cost savings, assuming the current prevalence of ARDS, were $237538 in ICU costs and $291682 in hospital costs. At a national level, using yearly incidence of ARDS cases in American ICUs, this represents $449 million in savings. Helmet NIV, compared to face mask NIV, in nonintubated patients with ARDS, reduces ICU and hospital direct-variable costs along with intubation rates, LOS, and mortality. A large-scale cost-effectiveness analysis is needed to validate the findings.

Oxygen therapy via a noninvasive helmet: A COVID-19 novelty with potential post-pandemic uses

“…The cost of each hood is measured in hundreds of dollars as opposed to the thousands of dollars range when compared with mechanical ventilation. Furthermore, this therapy decreases overall hospital costs associated with the prolonged ICU admission mechanical ventilation entails [ 17 ]. While the rubberneck gaskets are used for single patients due to the customized sizing procedure required, the hoods can be sterilized and reused on multiple patients.…”

The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

“…The superiority of helmets is even more remarkable considering that the ventilator setting with the helmet was not optimized according to the principles described above and the likelihood that some CO 2 rebreathing occurred. Moreover, helmet use could also be cost-effective [ 73 , 74 ]. Helmet NPPV might also be used as an alternative to invasive ventilation during the weaning phase, with a similar ventilatory support duration but fewer infectious complications [ 75 ].…”

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

“…It may be related to the fact that most of the primary causes of hypoxemic ARF are reversible, while most of the primary diseases leading to hypercapnic ARF are irreversible. In addition, some researchers conducted economic analysis [49] showed that the cost of ICU and hospitalization of the helmet NIMV group was significantly lower than that of the face mask NIMV group, reflecting considerable economic advantage.…”