StarMed clinical evidence

Published studies on the StarMed range of CPAP and NIV respiratory hoods. For more information on the full StarMed range, including information sheets, videos and enquiries, please visit

Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study

Coppo, Anna et al. The Lancet Respiratory Medicine. 2020; Volume 8, Issue 8, 765-774

This prospective cohort study aimed to assess the feasibility and effect on gas exchange of prone positioning in 56 awake, non-intubated patients with COVID-19-related pneumonia. Several variables were evaluated including demographics, anthropometrics, arterial blood gas, and ventilation parameters. The primary measured outcome was the variation in oxygenation between baseline and resupination, which served as an index of pulmonary recruitment. Findings have shown that prone positioning in awake, spontaneously breathing patients is achievable outside of the critical care environment in the majority of the patients. Improvements have been observed in oxygenation via Helmet CPAP interface (n=44), reservoir mask (n=9) and Venturi mask (n=3), during prone position, which was preserved upon resupination by half of the patients for 1 hour or more, as well as non-significant reduction in dyspnoea. Furthermore, patient discomfort was minimal and prone position was found to be a valuable patient engaging technique that improved blood gas parameters in the short term in patients with COVID-19-related pneumonia.

Link to abstract

Helmet continuous positive airway pressure and prone positioning: A proposal for an early management of COVID-19 patients

Longhini F, Bruni A, Garofalo E, et al. Pulmonology. 2020;26(4):186-191

This study set out to investigate the safety and efficacy of combining helmet CPAP (hCPAP) and prone position in order to avoid deterioration of gas exchange and intubation in patients with COVID-19 induced pneumonia. Preliminary results from an ongoing study in COVID-19 patients, measuring tidal volume during hCPAP, showed a low mean tidal volume, high pulmonary compliance and low respiratory rate, which translates in a low transpulmonary pressure. At this stage the real effects and efficacy of hCPAP from the pathophysiological stand point is not known. In healthy patients, findings suggest that redistribution of perfusion could improve oxygenation in patients lacking hypoxic vasoconstriction. If the hypothesis presented in this study is confirmed, this may reduce the requirement for endotracheal intubation, invasive mechanical ventilation, hospital length of stay and improving the survival rates. Moreover, it could also reduce the need for ICU beds, which can be substituted by sub-intensive beds.

Link to abstract


Helmet-based noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease: A case report

Park MH, Kim MJ, Kim AJ, Lee MJ, Kim JS. World J Clin Cases. 2020;8(10):1939-1943.

This report described a case of a 73-year-old man with COPD (stage 4) admitted to the ICU with complaints of cough, sputum, and dyspnoea. The patient was previously treated with oxygen at home for 10 months during the day time and oronasal mask-based NIV during night time. At the time of admission, the infection was detected and infiltration was also present. He was subsequently diagnosed with AECOPD by community-acquired pneumonia. Conditions deteriorated and invasive ventilation became unavoidable. However, helmet-based NIV was chosen as the patient refused to proceed with the invasive procedure. After three days of helmet NIV, he regained consciousness and hypercapnia recovered to pre-hospitalisation levels. This report demonstrates that helmet-based NIV may be a crucial treatment strategy used to treat patients with AECOPD that refuse invasive approaches and oronasal mask-based NIV is non-effective.

Link to abstract.

The ‘‘helmet bundle” in COVID-19 patients undergoing non-invasive ventilation

Lucchini A, Giani M, Isgrò S, Rona R, Foti G. Intensive Crit Care Nurs. 2020;58:102859

The COVID-19 outbreak represents a new challenge for intensive care teams, and of particular importance is the limitation of virus aerosolisation during intubation, bronchoscopy and non-invasive ventilation. As a result, the use of helmet ventilation has been suggested for CPAP and pressure support ventilation to reduce the spread of the virus. This letter suggests a helmet CPAP bundle to improve the patient’s comfort during extended applications by reducing the noise with an HME filter, using counterweights attached to armpit straps to avoid discomfort , as well as implementing active humidification.

Link to abstract.


Helmet CPAP vs. oxygen therapy in severe hypoxemic respiratory failure due to pneumonia

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.