Study: Helmet-based Ventilation Superior to Face Mask for Patients With Respiratory Distress

A new study shows that using a transparent air-tight helmet instead of a face mask helps critically ill patients breathe better and can prevent them from needing a ventilator. Patients with helmet ventilation also spent less time in the intensive care unit and had better survival.

The study, published early online, May 15, 2016, in JAMA, followed 83 patients suffering from acute respiratory distress syndrome (ARDS), which causes fluid to accumulate in the lungs’ microscopic air sacs and can lead to partial collapse of the lungs, dangerously low blood-oxygen levels and death.

The subjects in this study all required mechanical breathing assistance. They were randomly assigned to receive some form of noninvasive ventilation, using either a standard mask, strapped onto the face and covering the nose, mouth and chin; or the helmet, which surrounds the patient’s entire head and is sealed with a soft air-tight collar that wraps around the patient’s neck.

“In this group of critically ill patients, the helmet made a substantial difference,” said pulmonologist John P. Kress, MD, professor of medicine at the University of Chicago and senior author of the study. “The University’s data and safety monitoring board recommended that we stop the trial early because the helmet consistently demonstrated multiple advantages, particularly the reduced need to intubate patients and longer-term reduction in mortality.”

The helmet “confers several advantages over the face mask,” the authors wrote. It is less likely to leak. This enables the care team to increase air pressure into the helmet, which helps keep the airway and lungs open and improves oxygen levels. It is also more comfortable, easier to tolerate because it doesn’t touch the face, and patients can see through it well enough to watch television, talk or read.

The helmets used in this study are distributed by Sea-Long Medical Systems, Inc, based in Louisville, KY. One helmet costs about $100.

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