COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Comparison of noninvasive ventilation by sequential use of mask and helmet versus mask in acute exacerbation of chronic obstructive pulmonary disease: a preliminary study

Vittorio Antonaglia, Massimo Ferluga, Rossella Molino, Umberto Lucangelo, Alberto Peratoner, Erik Roman-Pognuz, Loredana De Simoni, Walter A Zin
Respiration; International Review of Thoracic Diseases 2011, 82 (2): 148-54
21447934

BACKGROUND: Noninvasive positive pressure ventilation (NPPV) using a face mask is the ventilatory mode of choice in selected patients experiencing acute exacerbation of chronic obstructive pulmonary disease (COPD). A high incidence of intolerance limits the use of this approach.

OBJECTIVE: To evaluate the sequential use of mask and helmet during NPPV in patients with severe exacerbation of COPD in order to reduce the intolerance to these devices.

METHODS: Fifty-three patients ventilated for the first 2 h with NPPV by mask were studied. If gas exchange and clinical status improved, they were randomized to continue on NPPV by mask or helmet. Physiological parameters were measured at admission, after the first 2 h on NPPV by mask, 4 h after randomization and at discharge. Need for intubation, ventilatory assistance, length of stay (LOS) and complications were recorded.

RESULTS: After the first 2 h of NPPV, gas exchange and clinical parameters improved in 40 patients. Four hours after randomization, PaCO(2) was lower in the mask group than in the helmet group. Nine patients in the mask group and 2 in the helmet group failed NPPV, 8 and 1, respectively, owing to intolerance. Time of noninvasive ventilation and LOS were lower in the mask than in the helmet group.

CONCLUSIONS: In patients with acute exacerbation of COPD and undergoing NPPV, the sequential use of a mask and helmet diminished the incidence of failure. Under the present experimental conditions, the use of a helmet increased LOS and the duration of artificial ventilation.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
21447934
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"