Helmet-Based Ventilation on "Exhale with Vitalograph" Podcast
Helmet-based ventilation offers advantages and benefits for patients and clinicians who use it.
“It’s the only universal device that can allow patients to breathe normally without causing any pain, facial skin ulcers, and necrosis,”
Savickaite said, noting patients who use face masks have these issues. “And it also allows you to keep the therapy uninterrupted while still allowing patients to eat and drink. And that can increase better outcomes for these patients.”
Some hospitals use helmets for ICU patients who require more than a day of non-invasive ventilation, she said – up to two weeks in Italy, for example. “So you imagine that the comfort for the patient is extremely important during that time because a lot of people will fail non-invasive ventilation due to the interface that is not comfortable,” she said.
Savickaite took part in a three-year study at the University of Chicago (published in JAMA in 2016) in which immunocompromised patients with acute respiratory distress syndrome used helmet-based ventilation or face masks. The results found those using helmets were less likely to be intubated, and they spent fewer days in the hospital and ICU.
Not every patient can use a face mask but the helmet interface has fewer contraindications. Some people have facial contours that make it difficult to fit a mask, for example, those who have no teeth, who are older, who have facial hair, or who have trauma or burns to the face, she said.
Post-op patients can also use helmets. They are especially helpful for obese and overweight patients who will benefit from PEEP (positive end-expiratory pressure). Helmets also can be used to make the transition from the ventilator to extubation much easier, she said.
For palliative care or do not intubate patients, helmets provide a comfortable alternative that can be used for a longer period of time, she said.
Helmets can be used with patients who have pneumonia or ARDS, but they need to be watched closely, Savickaite warned, “because, as you know, delay in intubation is never a good outcome for anyone. So you always want to watch these patients closely and be ready to intubate if you see any signs of failure.”
Clinicians can experience benefits from helmets, too.
“Another feature that I love is that you can prevent the spread of infection into the environment. The helmet has a very good seal around the neck, all the air that is leaving the patient is filtered out from the helmet via the HEPA filter,” Savickaite said.
“As a nurse who worked at the bedside for many years and saw many patients who use non-invasive ventilation, I also can say that helmets will reduce that workflow for the nurses and respiratory therapists,” Savickaite said.
Medical staff are tired and burned out from working long hours, she noted. “If we can do something to help them lower that workload and still reach great outcomes for the patient, that’s a win-win situation.”