Comparison of the clinical outcomes of non-invasive ventilation by helmet vs facemask in patients with acute respiratory distress syndrome

Mohamad Y Khatib, Mohamed Z Peediyakkal, Moustafa S Elshafei, Hani S Elzeer, Dore C Ananthegowda, Muhsen A Shahen, Wael I Abdaljawad, Karimulla S Shaik, Nevin Kannappilly, Ahmed S Mohamed, Ahmed A Soliman, Abdulqadir J Nashwan, Mohamad Y Khatib, Mohamed Z Peediyakkal, Moustafa S Elshafei, Hani S Elzeer, Dore C Ananthegowda, Muhsen A Shahen, Wael I Abdaljawad, Karimulla S Shaik, Nevin Kannappilly, Ahmed S Mohamed, Ahmed A Soliman, Abdulqadir J Nashwan

Abstract

Abstract: The main aim of this study is to compare the use of non-invasive ventilation (NIV) via helmet versus face mask where different interfaces and masks can apply NIV. However, some of the limitations of the NIV face mask were air leak, face mask intolerance, and requirement of high positive end expiratory pressure, which could be resolved with the use of the helmet NIV. NIV facemask will be applied as per the facial contour of the patient. NIV helmet is a transparent hood and size will be measured as per the head size. Both groups will have a standard protocol for titration of NIV.Patients aged more than 18 years old and diagnosed with acute respiratory distress syndrome as per Berlin definition will be enrolled in the study after signing the informed consent. Subjects who met the inclusion criteria will receive 1 of the 2 interventions; blood gases, oxygenation status [Po2/Fio2] will be monitored in both groups. The time of intubation will be the main comparison factor among the 2 groups. The primary and secondary outcomes will be measured by the number of patients requiring endotracheal intubation after application of helmet device, Improvement of oxygenation defined as PaO2/FiO2 ≥ 200 or increase from baseline by 100, duration of mechanical ventilation via an endotracheal tube, intensive care unit length of stay, death from any cause during hospitalization at the time of enrolment, need for proning during the hospital stay, intensive care unit mortality, and the degree to which overt adverse effects of a drug can be tolerated by a patient including feeding tolerance.

Trial registration number: NCT04507802.

Protocol version: May 2020.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

References

    1. Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016;315:788–800.
    1. Estenssoro E, Dubin A, Laffaire E, et al. Incidence, clinical course, and outcome in 217 patients with acute respiratory distress syndrome. Crit Care Med 2002;30:2450–6.
    1. Frutos-Vivar F, Nin N, Esteban A. Epidemiology of acute lung injury and acute respiratory distress syndrome. Curr Opin Crit Care 2004;10:1–6.
    1. Al Kuwari HM, Rahim HFA, Abu-Raddad LJ, et al. Epidemiological investigation of the first 5685 cases of SARS-CoV-2 infection in Qatar, 28 February–18 April 2020. BMJ Open 2020;10:1–8.
    1. Soliman AT, Prabhakaran Nair A, Al Masalamani MS, et al. Prevalence, clinical manifestations, and biochemical data of type 2 diabetes mellitus versus nondiabetic symptomatic patients with COVID-19: A comparative study. Acta Bio Medica Atenei Parmensis 2020;91:1–9.
    1. Iqbal FM, De Sanctis V, Mushtaq K, et al. Prevalence, clinical manifestations, and biochemical data of hypertensive versus normotensive symptomatic patients with COVID-19: a comparative study. Acta Bio Medica Atenei Parmensis 2020;91:1–8.
    1. Nair AP, Al Masalamani MA, De Sanctis V, et al. Clinical outcome of eosinophilia in patients with COVID-19: a controlled study. Acta Bio Medica Atenei Parmensis 2020;91:1–0.
    1. Ferguson ND, Fan E, Camporota L, et al. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med 2012;38:1573–82.
    1. Force ADT, Ranieri V, Rubenfeld G, et al. Acute respiratory distress syndrome. JAMA 2012;307:2526–33.
    1. Greene R, Lind S, Jantsch H, et al. Pulmonary vascular obstruction in severe ARDS: angiographic alterations after iv fibrinolytic therapy. Am J Roentgenol 1987;148:501–8.
    1. Hess DR. Noninvasive ventilation for acute respiratory failure discussion. Resp Care 2013;58:950–72.
    1. Hess DR, Fessler HE. Respiratory controversies in the critical care setting. Should noninvasive positive-pressure ventilation be used in all forms of acute respiratory failure? Res Care 2007;52:568–78.
    1. Berg KM, Clardy P, Donnino MW. Noninvasive ventilation for acute respiratory failure: a review of the literature and current guidelines. Intern Emerg Med 2012;7:539–45.
    1. Carrillo A, Gonzalez-Diaz G, Ferrer M, et al. Non-invasive ventilation in community-acquired pneumonia and severe acute respiratory failure. Intensive Care Med 2012;38:458–66.
    1. Thille AW, Contou D, Fragnoli C, et al. Non-invasive ventilation for acute hypoxemic respiratory failure: intubation rate and risk factors. Critical Care 2013;17:1–8.
    1. Antonelli M, Conti G, Esquinas A, et al. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med 2007;35:18–25.
    1. Schwartz AR, Kacmarek RM, Hess DR. Factors affecting oxygen delivery with bi-level positive airway pressure. Resp Care 2004;49:270–5.
    1. Patel BK, Wolfe KS, Pohlman AS, et al. Effect of noninvasive ventilation delivered by helmet vs face mask on the rate of endotracheal intubation in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 2016;315:2435–41.

Source: PubMed

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