Helmet-based non-invasive ventilation (NIV) is an advanced respiratory support method offering significant advantages over traditional face masks. The helmet, a transparent hood sealed around the neck, improves patient comfort, reduces air leaks, and allows for better communication and nutrition intake. It does not have any pressure points on the face, thereby it’s possible to improve device tolerance without the risk of skin necrosis.^[1]

Moreover, a recent study conducted in patients with acute respiratory distress syndrome (ARDS) demonstrated good outcomes in patients with helmet interface NIV. Among patients with ARDS, treatment with helmet NIV resulted in a significant reduction of intubation rates^[1]. Also, helmet NIV has been associated with improved oxygenation and lower inspiratory effort compared to high-flow nasal oxygen therapy^[2].

This infographics clearly shows the advantages of this type of ventilation in comparison with other interfaces (source).

Ventilation with a helmet in UVENT-S ICU ventilators

NIV mechanical ventilation with a helmet is implemented in UVENT-S ICU ventilators as a separate mode. The helmet’s larger internal volume may predispose patients to CO₂ rebreathing. Adequate flow rates and proper ventilator settings are crucial to mitigate this risk.^[3] So ventilation with the helmet is operated with adjustable CO2 “washing out” base flow and the permanent base pressure level defined by PEEP.

• Special mode with the adjustable base flow up to 70 l/min to eliminate CO₂ rebreathing.
• Patient can interact with clinicians during treatment, to drink or even eat through a special port.
• WHO recommends helmet use for NIV in new guidelines.^[4]

Helmet-based NIV, combined with modern ventilator technologies, is a promising solution for improved respiratory care in critical settings.

References

1. Patel, et al. Effect of noninvasive ventilation delivered by helmet vs face mask on the rate of endotracheal intubation in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA. 2016;315(22):2435-2441. doi:10.1001/jama.2016.6338.

2. Cesarano, et al. Helmet noninvasive support for acute hypoxemic respiratory failure: rationale, mechanism of action and bedside application. Ann Intensive Care. 2022;12:94. doi:10.1186/s13613-022-01069-7.

3. Esquinas, et al. Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients. Crit Care. 2013 Apr 25;17(2):223. doi:10.1186/cc11875.

4. Clinical care of severe acute respiratory infections – Tool kit. COVID-19 adaptation, update 2022. WHO, 6 April 2022 | COVID-19: Clinical care