CPAP and NPPV are often lumped together under the broad umbrella of “NIV”, but distinguishing between these two forms of support is crucial. The second section is dedicated to noninvasive positive pressure ventilation (NPPV), which offers active support for inspiration (typically by pressure support) delivered by a mechanical ventilator. During CPAP, the patient is free to inhale or exhale, while the pressure within the helmet remains constant, and there is no interaction with a ventilator and no “active" inspiratory support. The first is dedicated to the use of helmets in the delivery of continuous positive airway pressure (H-CPAP), typically powered by a continuous free-flow system and a PEEP valve.
This review is divided into two main sections. As discussed in detail below, the advantages of helmets result from their tolerability (noise representing a possible limitation), cost-effectiveness and excellent sealing capability (minimizing leaks), the latter being obtained easily and involving very gentle contact, resulting in minimal risk of soft tissue injury. The helmet typically has two (or more) connectors for the gas inlet and outlet O 2-enriched gas can be provided by a Venturi system, a turbine flow generator or a ventilator. Given the increasing use of this interface, we considered it worth summarizing the available knowledge on the topic.Ī helmet is constituted by a soft (but nonextensible) transparent hood that fits over the patient’s entire head without any contact point and is anchored (in some cases by a rigid ring) to a soft and extensible collar that fits gently around the patient’s neck. Helmets have been in use since the early 2000s, albeit mostly only in a few countries, Italy in particular. During the COVID-19 pandemic, increased attention has been devoted to the use of helmets. Noninvasive ventilatory support (NIV) is frequently used in the treatment of several forms of acute (or acute-on-chronic) respiratory failure.
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