Yuwen Luo, Yan Luo, Yun Li, Luqian Zhou, Zhe Zhu, Yitai Chen, Yuxia Huang, and Xin Chen. Yonsei Med J. 2016 Jul 1; 57(4): 936–941.
This meta-analysis aimed to investigate the effects of helmet CPAP on gas exchange, mortality, intubation rate and in-hospital mortality rate in comparison with the conventional oxygen therapy (COT). Data obtained from four studies and 377 subjects with hypoxemic acute respiratory failure (hARF) showed that helmet CPAP significantly increased the PaO2/FiO2, and reduced the arterial carbon dioxide levels, intubation rate and in-hospital mortality rates as compared to COT therapy. These results suggest that the helmet improves oxygenation, reduces mortality and intubation rates. However, large randomised controlled trials are needed to validate these findings.
Link to abstract.
Patel BK, Wolfe KS, Pohlman AS, Hall JB, Kress JP. JAMA. 2016 Jun 14;315(22):2435-41
Single-centre randomised trial of 83 patients to determine whether NIV through helmet improves intubation rate among patients with ARDS. Primary outcome was proportion of patients who needed ETI, secondary outcomes included 28-day invasive ventilator-free days, ICU length of stay, and 90-day mortality. Authors conclude helmet NIV treatment resulted in a significant reduction of intubation rates as well as statistically significant reduction in 90-day mortality.
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.
Barbagallo M, Ortu A, Spadini E, Salvadori A, Ampollini L, Internullo E, Ziegler S, Fanelli G. Respir Care. 2012 Sep;57(9):1418-24
Randomised trial of 50 patients allocated to receive either continuous oxygen therapy or two cycles of helmet CPAP for 120 minutes. Results suggest that by the end of the second helmet treatment, patient's had a significantly higher PaO2/FiO2 but the improvement in oxygenation was not lasting. However, helmet CPAP was 'secure and well tolerated'.
Link to abstract.
Cosentini R, Brambilla AM, Aliberti S, Bignamini A, Nava S, Maffei A, Martinotti R, Tarsia P, Monzani V, Pelosi P.
Chest. 2010 Jul;138(1):114-20
Multi-centre, randomised controlled trial. 47 patients admitted to ED with moderate hypoxemic acute respiratory failure (ARF) due to community-acquired pneumonia (CAP) were split into helmet CPAP or standard oxygen therapy groups. Primary end point was time to reach PaO2/FiO2 ratio > 315. The proportion of patients who reached the primary end point was also recorded. Authors conclude that CPAP delivered by helmet rapidly improves oxygenation in this scenario.
Link to abstract.