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- Title
Performance of different continuous positive airway pressure helmets equipped with safety valves during failure of fresh gas supply.
- Authors
Milan, Manuela; Zanella, Alberto; Isgrò, Stefano; Deab, Salua; Magni, Federico; Pesenti, Antonio; Patroniti, Nicolò
- Abstract
Purpose: We assessed the performance of different continuous positive airway pressure (CPAP) helmets equipped with a safety valve during discontinuation of fresh gas flow. Methods: This was a physiological study of five healthy volunteers. We delivered CPAP (fresh gas flow 60 l/min, FiO 60%, PEEP 5 cmHO) with three different helmets in a random sequence: 4Vent (Rüsch), HelmHAR-cp (Harol) and CaStar CP210 (StarMed). For each helmet we randomly applied, for up to 4 min, three disconnections of fresh gas flow: helmet inlet (D), flowmeter (D) and gas source (D). We continuously recorded from a nostril: end-tidal CO (PetCO), inspiratory CO (PiCO), fraction of inspired oxygen (FiO) and respiratory rate (RR). Results: During every disconnection we observed an increase in PiCO and PetCO with a drop in FiO, while RR did not change. FiO decreased more quickly in the CaStar, equipped with the largest safety valve, during D and D, while FiO decreased more quickly during D in CaStar and in 4Vent. PiCO resulted in a lower increase in CaStar during D and D compared to 4Vent. PetCO in CaStar increases more slowly compared to 4Vent during D and more slowly compared to the other two helmets during D. During D similar degrees of CO rebreathing and PetCO were recorded among all the helmets. Conclusions: To minimize CO rebreathing during disconnection of the fresh gas supply while performing helmet CPAP, it is desirable to utilize large helmets with a large anti-suffocation valve. Monitoring and alarm systems should be employed for safe application of helmet CPAP.
- Subjects
HELMETS -- Design &; construction; CONTINUOUS positive airway pressure; RELIEF valves; GAS flow; FLOW meters; ASPHYXIA; PREVENTION
- Publication
Intensive Care Medicine, 2011, Vol 37, Issue 6, p1031
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-011-2207-3