Comparison of helmet versus face mask interface for noninvasive ventilation in patients with acute cardiogenic pulmonary oedema— A randomized controlled trial

Chatterjee R, Singh S, Chhabra PH, Kherwal R, Aggarwal D

Pdf Page Numbers :- 129-133

Ranajit Chatterjee¹, Snigdha Singh², Priyanka H Chhabra^3,*, Rajni Kherwal¹ and Deepti Aggarwal¹

¹Intensive Care Unit, Swami Dayanand Hospital, New Delhi, Delhi 110095, India

²Department of Anaesthesia and Intensive Care, Maulana Azad Medical College (MAMC), Balmiki Basti, New Delhi, Delhi 110002, India

³Department of Anaesthesiology & Critical Care, Vardhaman Mahavir Medical College & Safdarjung Hospital, Safdarjung Campus, Ansari Nagar West, New Delhi, Delhi 110029, India

*Corresponding author: Dr. Priyanka H Chhabra, Associate Professor, Department of Anaesthesiology & Critical Care, Vardhaman Mahavir Medical College & Safdarjung Hospital, Safdarjung Campus, Ansari Nagar West, New Delhi, Delhi 110029, India. Email: priyankahsinghani@gmail.com

Received 18 January 2024; Revised 21 February 2024; Accepted 29 February 2024; Published 12 March 2024

Citation: Chatterjee R, Singh S, Chhabra PH, Kherwal R, Aggarwal D. Comparison of helmet versus face mask interface for noninvasive ventilation in patients with acute cardiogenic pulmonary oedema— A randomized controlled trial. J Med Sci Res. 2024; 12(2):129-133. DOI: http://dx.doi.org/10.17727/JMSR.2024/12-24

Copyright: © 2024 Chatterjee R et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Non-invasive ventilation (NIV) is strongly recommended in patients with acute cardiogenic pulmonary oedema (ACPE). Recently, helmet has been introduced as an interface for NIV. This study was planned to compare helmet and face mask interface for administering NIV.

Methods: This was a prospective, randomized control trial conducted in patients with ACPE with respiratory failure treated with either face masks or helmet. Patients in Group H (Helmet) received minimum positive end expiratory pressure (PEEP) of 10, with a pressure support (PS) of 15. The cushion was inflated to 100 cm H20 and pressurization/ rise time was kept 0.1 seconds. Group F (Facemask) patients received pressure support with expiratory positive airway pressure (EPAP) of 8 and inspiratory positive airway pressure (IPAP) of 16 cm H20. EPAP & IPAP were adjusted according to tidal volume (TV) and respiratory rate (RR) respectively.

Results: Patients using helmet as the interface had less failure rate (0.0%) as compared to facemask 9 (22.5%), Odds Ratio (OR)[95% Confidence Interval (CI)]- 0.04 (0.0, 0.71) (p= 0.001) and less complications such as nasal and skin ulcers 3 (8.6%) in Group H as compared to 16 (45.7%) in Group F, OR (95% CI) o--0.11 (0.03,0.43) (p= 0.01).

Conclusion: Helmet was better than face mask in terms of reduced requirement of intubations, better patient tolerance and reduced complications.

Keywords: intubation; mask; non-invasive ventilation; ulcers