Helmet continuous positive airway pressure for patients’ transport using a single oxygen cylinder: A bench study

Ambulances; Continuous positive airway pressure; Emergency medical services; Hypoxemic respiratory failure; Non-invasive ventilation; Transportation of patients; Continuous Positive Airway Pressure; Equipment Design; Humans; Oxygen; Oxygen Inhalation Therapy; Respiratory Insufficiency; Transportation of Patients; oxygen; continuous positive airway pressure; devices; equipment design; human; oxygen therapy; patient transport; procedures; respiratory failure; therapy

Abstract :

[en] Background: Continuous positive airway pressure (CPAP) is frequently used to treat patients with acute respiratory failure in out-of-hospital settings. Compared to a facemask, the helmet has many advantages for the patient but requires a minimum gas flow of 60 L/min to avoid CO2 rebreathing. The aim of the present bench study was to evaluate the performance of four Venturi devices, connected to a single oxygen cylinder, in delivering helmet-CPAP with clinically relevant gas flow, fraction of inspired oxygen (FiO2), and positive end-expiratory pressure (PEEP) values. Methods: Three double-inlet Venturi systems (EasyVent, Ventuplus, Compact-HAR) were connected to full 5-L oxygen cylinders using a double flowmeter, and their oxygen requirements to reach different setups (flow 60-80 L/min; FiO2 0.4-0.5-0.6, PEEP 7.5-10-12.5 cmH2O) were tested. The fourth Venturi system (O2-MAX) was directly attached to the tank, and the flow and FiO2 delivered at preset FiO2 0.3 and 0.6 were recorded. The runtime of the cylinder was assessed. Results: EasyVent, Ventuplus, and O2-MAX were able to deliver helmet-CPAP with clinically useful setups when connected to a single oxygen cylinder, while Compact-HAR did not. The runtime of the cylinders ranged between 28 and 60 minutes according to the preset flow and FiO2. The delivered gas flow decreased slowly and linearly with the drop in cylinder pressure until its exhaustion. Conclusions: Helmet-CPAP might be provided using portable Venturi systems connected to an oxygen cylinder, but not all of them are able to deliver it. The use of a double flowmeter allows delivery of both high flow and high FiO2 when double-inlet Venturi systems are used. Due to the flow drop observed during the cylinder consumption, a flow >60 L/min should be set when helmet-CPAP is started. Considering the flow drop phenomenon, the estimated duration of the tank runtime can be used with a margin of safety when planning patient transport. © 2023 Sociedade Portuguesa de Pneumologia

Disciplines :

Anesthesia & intensive care

Author, co-author :

Capsoni, N; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy ; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy

Zadek, F; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy

PRIVITERA, Daniele ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Life Sciences and Medicine (DLSM) > Medical Education ; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Parravicini, G; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Zoccali, G V; Department of Anesthesia and Intensive Care Medicine, Niguarda Ca’ Granda, Milan, Italy

Galbiati, F; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

Bombelli, M; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy

Fumagalli, R; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy ; Department of Anesthesia and Intensive Care Medicine, Niguarda Ca’ Granda, Milan, Italy

Langer, T; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy ; Department of Anesthesia and Intensive Care Medicine, Niguarda Ca’ Granda, Milan, Italy

External co-authors :

Language :

English

Title :

Helmet continuous positive airway pressure for patients’ transport using a single oxygen cylinder: A bench study

Publication date :

2023

Journal title :

Pulmonology

ISSN :

2531-0429

eISSN :

2531-0437

Publisher :

Elsevier Espana S.L.U

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBilu :

since 26 November 2025

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