Italy is in the midst of a “tsunami,” according to Prof. Antonio Pesenti, head of Lombardy intensive-care crisis unit. Pesenti is a professor of Anesthesiology and Intensive Care Medicine at the University of Milan, Italy.
Yesterday, Prof. Pesenti spoke to John P. Kress, MD, about the helmet ventilation use during the COVID-19 crisis in Italy. Pesenti had predicted high numbers of patients would require intensive care in hospitals, more than they could handle.
He told Dr. Kress that about 20% - 35% of patients improve on noninvasive ventilation (NIV) via the helmet. Prof. Pesenti said that when you apply the helmet, you will see results in one to two hours of helmet ventilation. Physicians will see if a patient needs intubation or is recovering from respiratory distress.
According to the International Pulmonologist’s Consensus on COVID-19 guidelines we should not use noninvasive positive pressure for COVID-19 patients to prevent the spread of the virus. However, by using NIV via helmet with an antiviral filter creates a closed system to prevent the virus from passing from the patient to the medical staff. Successful use of helmets in Italy shows they are safe and can be used by US hospitals.
Excerpt from: “International Pulmonologist’s Consensus on COVID-19” Chief editors: Dr.Tinku Joseph (India), Dr. Mohammed Ashkan Moslehi (Iran).
NIV via helmet regularly is used in Italy but is not common in the US. Helmets were used in one hospital during a three-year study. Dr. Kress co-authored a report of that study of helmet-based ventilation at the University of Chicago Medical Center that found patients recovered faster and were less likely to be intubated compared to those using NIV face masks.
The Lombardy region in northern Italy experienced the first cases of COVID-19 in the country and has been the hardest hit in Italy.
Dr. Kress is a professor of medicine, specializing in pulmonary medicine and critical care medicine. He is the director of the Medical Intensive Care Unit at the University of Chicago Medicine. He is an advisor for HelmetBasedVentilation.com.