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Performance of different continuous positive airway pressure helmets equipped with safety valves during failure of fresh gas supply.
MedLine Citation:
PMID:  21448714     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: We assessed the performance of different continuous positive airway pressure (CPAP) helmets equipped with a safety valve during discontinuation of fresh gas flow. METHODS: This was a physiological study of five healthy volunteers. We delivered CPAP (fresh gas flow 60 l/min, FiO(2) 60%, PEEP 5 cmH(2)O) with three different helmets in a random sequence: 4Vent (Rüsch), HelmHAR-cp (Harol) and CaStar CP210 (StarMed). For each helmet we randomly applied, for up to 4 min, three disconnections of fresh gas flow: helmet inlet (D(inlet)), flowmeter (D(flowmeter)) and gas source (D(source)). We continuously recorded from a nostril: end-tidal CO(2) (PetCO(2)), inspiratory CO(2) (PiCO(2)), fraction of inspired oxygen (FiO(2)) and respiratory rate (RR). RESULTS: During every disconnection we observed an increase in PiCO(2) and PetCO(2) with a drop in FiO(2), while RR did not change. FiO(2) decreased more quickly in the CaStar, equipped with the largest safety valve, during D(source) and D(flowmeter), while FiO(2) decreased more quickly during D(inlet) in CaStar and in 4Vent. PiCO(2) resulted in a lower increase in CaStar during D(source) and D(flowmeter) compared to 4Vent. PetCO(2) in CaStar increases more slowly compared to 4Vent during D(source) and more slowly compared to the other two helmets during D(flowmeter). During D(inlet) similar degrees of CO(2) rebreathing and PetCO(2) were recorded among all the helmets. CONCLUSIONS: To minimize CO(2) rebreathing during disconnection of the fresh gas supply while performing helmet CPAP, it is desirable to utilize large helmets with a large anti-suffocation valve. Monitoring and alarm systems should be employed for safe application of helmet CPAP.
Authors:
Manuela Milan; Alberto Zanella; Stefano Isgrò; Salua Abd El Aziz El Sayed Deab; Federico Magni; Antonio Pesenti; Nicolò Patroniti
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-30
Journal Detail:
Title:  Intensive care medicine     Volume:  -     ISSN:  1432-1238     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza, MB, Italy.
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