Prolonged use of the Non-Invasive Ventilation Helmet in Acute Respiratory Distress Syndrome

Abstract

The management of acute respiratory distress syndrome (ARDS) with non-invasive ventilation (NIV) is controversial. We report a case of a 69-year-old patient who developed ARDS after elective total hip replacement. During a 33-day stay in the intensive care unit (ICU) his respiratory failure was successfully managed with intermittent NIV through a transparent ventilation helmet, when he became intolerant of the facemask. Nearly four days were spent almost continuously in the NIV hood. The origin of the ARDS was never confirmed; possible causes included amiodarone toxicity, atypical pneumonia and fat embolus. The patient remained awake throughout, never exceeded single-organ failure, his respiratory function improved gradually and he was eventually discharged home.

Haemodialysis: Solving a Shortfall in Consumables

“…When compared with tight fitting masks, hoods/helmets reduce the risk of skin necrosis, are less claustrophobic and have been shown to be well tolerated by patients for extended periods. [1][2][3] However, since these systems exert continuous positive pressure on all structures enclosed within the hood/helmet, we are concerned that this may elevate intraocular pressure (IOP) and potentially worsen symptoms of glaucoma in patients with pre-existing intraocular hypertension or precipitate retinal ischaemia secondary to reductions in retinal arterial flow. While long-term maskdelivered CPAP has been shown to cause an increase in IOP and reduction in ocular perfusion pressure in some patient populations, 4,5 the magnitude and clinical significance of such effects in intensive care patients receiving CPAP via a hood/helmet are unknown.…”

Ocular Complications Resulting from the use of CPAP Hoods/Helmets

“…When compared with tight fitting masks, hoods/helmets reduce the risk of skin necrosis, are less claustrophobic and have been shown to be well tolerated by patients for extended periods. [1][2][3] However, since these systems exert continuous positive pressure on all structures enclosed within the hood/helmet, we are concerned that this may elevate intraocular pressure (IOP) and potentially worsen symptoms of glaucoma in patients with pre-existing intraocular hypertension or precipitate retinal ischaemia secondary to reductions in retinal arterial flow. While long-term maskdelivered CPAP has been shown to cause an increase in IOP and reduction in ocular perfusion pressure in some patient populations, 4,5 the magnitude and clinical significance of such effects in intensive care patients receiving CPAP via a hood/helmet are unknown.…”