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Intensive Care Medicine

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01-01-2007 | Brief Report

Danger of helmet continuous positive airway pressure during failure of fresh gas source supply

Authors: Nicolò Patroniti, Maurizio Saini, Alberto Zanella, Stefano Isgrò, Antonio Pesenti

Published in: Intensive Care Medicine | Issue 1/2007

Abstract

Objective

To assess the behavior of different helmets after discontinuation of fresh gas flow by disconnection at the helmet inlet, flow generator, or gas source.

Design and setting

Randomized physiological study in a university research laboratory.

Patients

Five healthy volunteers.

Intervention

CPAP (FIO₂ 50%, PEEP 5 cmH₂O) delivered in random sequence with three different helmets: 4Vent (Rüsch), PN500 (Harol), CaStar (StarMed) with antisuffocation valve open or locked. For each helmet all three disconnections were randomly employed up to 4 min.

Measurements and results

During flow disconnection we measured: respiratory rate and tidal volume by respitrace; inspiratory and expiratory CO₂ concentration, and FIO₂ from a nostril; SpO₂ by pulse oxymetry. Independently of the site of disconnection we observed a fast increase in CO₂ rebreathing and minute ventilation, associated with a decrease in inspired O₂ concentration. In the absence of an operational safety valve, larger helmet size and lower resistance of the inlet hose resulted in slower increase in CO₂ rebreathing. The presence of the safety valve limited the rebreathing of CO₂, and the increase in minute ventilation but did not protect from a decrease in FIO₂ and loss of PEEP.

Conclusions

While the use of a safety valve proved effective in limiting CO₂ rebreathing, it did not protect from the risk of hypoxia related to decrease in FIO₂ and loss of PEEP. In addition to a safety antisuffocation valve, a dedicated monitoring and alarming systems are needed to employ helmet CPAP safely.

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Title: Danger of helmet continuous positive airway pressure during failure of fresh gas source supply
Authors: Nicolò Patroniti
Maurizio Saini
Alberto Zanella
Stefano Isgrò
Antonio Pesenti
Publication date: 01-01-2007
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 1/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-006-0446-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Danger of helmet continuous positive airway pressure during failure of fresh gas source supply

Abstract

Objective

Design and setting

Patients

Intervention

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients

Intervention

Measurements and results

Conclusions

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