Physiological Effects of Helmet vs. Facemask Noninvasive Ventilation in Acute Hypoxemic Respiratory Failure
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Hypoxemic Respiratory Failure
- Sponsor
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Inspiratory effort
- Status
- Completed
- Last Updated
- 7 months ago
Overview
Brief Summary
The optimal noninvasive management of acute hypoxemic respiratory failure is debated. Helmet noninvasive ventilation may be more effective than facemask noninvasive ventilation for these patients. Putatitve benefits of helmet use are the possibility to apply significantly higher positive end-expiratory pressure without air leaks and with good patient's comfort.
In this randomized crossover study, the investigators will assess the physiological effects of helmet compared to facemask noninvasive ventilation, with the latter applied with different ventilator settings (similar to or different from helmet settings).
Investigators
Eligibility Criteria
Inclusion Criteria
- •Acute hypoxemic respiratory failure and PaO2/FiO2\<200 mmHg
- •PaCO2\<45 mmHg
- •Respiratory failure not caused by exacerbation of chronic pulmonary disease, cardiac failure or fluid overload
Exclusion Criteria
- •Pregnancy
- •Contraindication to helmet or facemask noninvasive ventilation
- •Contraindication to esophageal manometry
- •Contraindication to electrical-impedance tomography monitoring
- •Recent surgery involving the abdomen or the thorax
- •Pneumothorax or documented barotrauma
Outcomes
Primary Outcomes
Inspiratory effort
Time Frame: 1 hour
negative deflection in esophageal pressure
End-expiratory lung impedance
Time Frame: 1 hour
Electrical-impedance derived end-expiratory lung volume
Secondary Outcomes
- Tidal volume(1 hour)
- Discomfort(1 hour)
- Oxygenation(1 hour)
- Corrected minute ventilation(1 hour)
- Dynamic transpulmonary driving pressure(1 hour)
- Work of breathing(1 hour)
- Respiratory rate(1 hour)
- Dyspnea(1 hour)
- Pendelluft extent(1 hour)
- Compliance(1 hour)
- Arteria Carbon dioxide tension(1 hour)
- Tidal volume distribution(1 hour)