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Annals of Intensive Care
Fig. 3 | Annals of Intensive Care

Fig. 3

From: Helmet noninvasive support for acute hypoxemic respiratory failure: rationale, mechanism of action and bedside application

Fig. 3

Representative tracings of respiratory mechanics of a patient treated with helmet pressure support ventilation. Due to the high compliance of the interface, asynchronies are common during helmet NIV. Inspiratory and expiratory trigger delays are displayed, together with the slow increase and decay in airway pressure. Despite the short time of synchrony, the mean expiratory airway pressure is higher than the set PEEP (dotted lines in the Paw tracing) and the mean expiratory transpulmonary pressure is higher than the end-expiratory transpulmonary pressure (dotted lines in the PL tracing). Due to the significant trigger delays caused by interface compliance, inspiratory effort and ventilator assistance are (at least in part) out-of-phase, avoiding excessive dumps in transpulmonary pressure during inspiration. This de-synchronization may further enhance lung protection. Acronyms; PES, esophageal pressure; PL, transpulmonary pressure

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