Qi Liu, Yonghua Gao, Rongchang Chen and Zhe Cheng. Crit Care. 2016;20(1):265
This meta-analysis aimed to analyse the effects of NIV using the helmet in comparison to a control strategy in patients with acute respiratory failure (ARF). Primary outcomes were hospital mortality, intubation rate and complications and secondary outcomes included length of intensive care unit (ICU) stay, gas exchange and respiratory rate. Results from 11 studies and 621 patients demonstrated that the overall mortality was circa 18% in the helmet NIV group versus circa 31% in the in the control group. The helmet implementation was also linked with lower hospital mortality, intubation and complication rates. Furthermore, subgroup analysis showed that the helmet reduced mortality mainly in hypoxemic ARF patients and the PaCO2 was influenced by the type of ARF and ventilation mode. Thus, the helmet represents a superior approach to the conventional therapy, but additional larger studies must be carried out to confirm these results.
Link to abstract.
Brambilla AM, Aliberti S, Prina E, Nicoli F, Forno MD, Nava S, Ferrari G, Corradi F, Pelosi P, Bignamini A, Tarsia P, Cosentini R. Intensive Care Med. 2014 Jul;40(7):942-9
Multi-centre, randomised controlled trial across four Italian centres. Patients split into helmet CPAP and Venturi mask groups. Primary end point was percentage of patients meeting criteria for ETI. Authors conclude helmet CPAP reduces the risk of meeting ETI criteria in this scenario.
Link to abstract.
Dimech A. Nurs Crit Care. 2012 Jan-Feb;17(1):36-43
Research study using qualitative data to analyse the experiences of helmet CPAP. Results show experience was unique to each patient, with emergent themes including confusion, help to breathe, apprehensive and trust. Authors conclude the results indicate the basis for policy and guideline development in critical care departments.
Link to abstract.
Bellani G, Patroniti N, Greco M, Foti G, Pesenti A. Minerva Anestesiol. 2008 Nov;74(11):651-6
Review focusing on the properties of the helmet and the issues related to its use for the treatment of cardiogenic and non-cardiogenic pulmonary edema.
Link to abstract.
Antonelli M, Conti G, Esquinas A, Montini L, Maggiore SM, Bello G, Rocco M, Maviglia R, Pennisi MA, Gonzalez-Diaz G, Meduri GU. Crit Care Med. 2007 Jan;35(1):18-25
Prospective multi-centre cohort study across three European intensive care units with NPPV expertise, resulted in survey of 479 patients with ARDS. Authors conclude NPPV applied as first-line intervention avoided intubation in 54% of treated patients.
Link to abstract.