Cpap should be kept on as long as possible Helmet is the interface that allows the longer duration. On the other hand it is not conceivable to stay on CPAP for days therefore we should aim at least to 16-20 hrs/day in the first three days of treatment
An usual setting to start NIV in children with restrictive or mixed respiratory failure is PEEP 5-6 cmH2O plus Pressure Support 10 cmH2O
In general ward pts on Helmet CPAP no sedation at all or very low dosage of morphine
Sedation is generally administered in patients requiring long-term NIV and showing interface intolerance; an appropriate drug (being both sedative and analgesic) is Dexmedetomidine (at doses ranging from 0.4 to 1.4 micrograms/kg/h) in view of its lack of respiratory side-effects.
No technical difference: with bilevel setting the pressures applied are denominated as EPAP+IPAP instead than PEEP + PSV.
No . There are system to drive the helmet that use the Venturi principle to deliver high flow. Up to 80-100 L/min.
A ventilator equipped with a blower (aspirating ambient gases) instead than a gas-compressed ventilator
Yes. Using humidifier at lowest possible temperature setting in order to avoid fog formation inside the helmet. Chep and effective : Fisher and Pikel 810 (no conflict of interest)
We did it. Around 80% of proned pts where on Helmet CPAP
Yes. During relief period between the prolonged period of Helmet CPAP and when they improve as a technique of progressive weaning from CPAP.
It occurs very rarely. Much less than you would expect. In a true claustrophobic pts you cannot use the helmet
It was not much complicated. Remember that you can also use prone position also during standard O2 therapy and HFNC and is effective too