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

Annals of Intensive Care

Table 1 Helmet settings in patients with acute hypoxemic respiratory, with and without pressure support

Ventilatory setting	Helmet NIV	Helmet CPAP
Ventilatory circuit	Ventilator with bitube circuit and antimicrobial filter on expiratory port	High flow generator with PEEP valve and antimicrobial filter on expiratory port
PEEP	10–15 cmH₂O	10–15 cmH₂O
Pressure support	10–14 cmH₂O	–
Fresh gas flow	–	50–60 L/min
FiO₂	Titrated to obtain SpO₂ ≥ 92% and ≤ 98%	Titrated to obtain SpO₂ ≥ 92% and ≤ 98%
Pressurization rate	0.00 s (or fastest possible pressurization rate)	–
Inspiratory flow trigger	2 L/min or 2 cmH₂O	–
Cycling	10–50% of maximum inspiratory flow	–
Maximum inspiratory time	1.2 s	–
Gas conditioning	No humidification needed if minute ventilation < 35 L/min	Active heating and humidification (37 °C or 34 °C according to patient’s comfort)