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 https://www.intersurgical.com/info/starmed

Helmet CPAP to Treat Acute Hypoxemic Respiratory Failure in Patients with COVID-19: A Management Strategy Proposal

Radovanovic D, Rizzi M, Pini S, Saad M, Chiumello DA, Santus P. J Clin Med. 2020;9(4):1191

The author of this research study proposes a management strategy for the treatment of acute hypoxemic respiratory failure in patients with COVID-19. Respiratory support with NIV or high flow oxygen should be avoided to limit droplets/virus aerosolisation and healthcare worker contamination. Therefore, the implementation of CPAP through a helmet system may provide an effective and safer alternative to improve hypoxemia. In addition, the use of the helmet will also reduce room contamination and improve patient comfort, while guaranteeing better clinical assistance and long term tolerability. However, careful CPAP titration must be provided to better optimise the recruitment of unventilated lung sections to improve patient outcomes.

 

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.

 

New Setting of Neurally Adjusted Ventilatory Assist during Noninvasive Ventilation through a Helmet [CaStar R Next]

Cammarota G, Longhini F, Perucca R, Ronco C, Colombo D, Messina A, Vaschetto R, Navalesi P.
Anesthesiology. 2016 Dec;125(6):1181-1189

Randomised trial of 15 patients undergoing three 30-minutes ventilation trials using two different helmets. The ventiltion modes were randomly applied: pneumatically triggered pressure support ventilation (PSP), neurally adjusted ventilatory assist (NAVA) and neurally controlled pressure support (PSN). The latter is a new proposed setting of the NAVA mode. Authors conclude that PSN improves comfort and patient-ventilator interactions in this scenario.

Link to abstract.

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.

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.

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.