Carbon dioxide rebreathing during non-invasive ventilation delivered by helmet: a bench study.

Intensive Care Medicine
Francesco MojoliAntonio Braschi

Abstract

To define how to monitor and limit CO(2) rebreathing during helmet ventilation. Physical model study. Laboratory in a university teaching hospital. We applied pressure-control ventilation to a helmet mounted on a physical model. In series 1 we increased CO(2) production (V'CO(2)) from 100 to 550 ml/min and compared mean inhaled CO(2) (iCO(2),mean) with end-inspiratory CO(2) at airway opening (eiCO(2)), end-tidal CO(2) at Y-piece (yCO(2)) and mean CO(2) inside the helmet (hCO(2)). In series 2 we observed, at constant V'CO(2), effects on CO(2) rebreathing of inspiratory pressure, respiratory mechanics, the inflation of cushions inside the helmet and the addition of a flow-by. In series 1, iCO(2),mean linearly related to V'CO(2). The best estimate of CO(2) rebreathing was provided by hCO(2): differences between iCO(2),mean and hCO(2), yCO(2) and eiCO(2) were 0.0+/-0.1, 0.4+/-0.2 and -1.3+/-0.5%. In series 2, hCO(2) inversely related to the total ventilation (MVtotal) delivered to the helmet-patient unit. The increase in inspiratory pressure significantly increased MVtotal and lowered hCO(2). The low lung compliance halved the patient:helmet ventilation ratio but led to minor changes in MVtotal and hCO(2). Cushion inflation, althou...Continue Reading

References

Jun 13, 2003·Intensive Care Medicine·Davide ChiumelloLuciano Gattinoni
Oct 18, 2003·Intensive Care Medicine·Nicolò PatronitiAntonio Pesenti
Oct 16, 2004·Critical Care Medicine·Paolo TacconeLuca M Bigatello
Oct 16, 2004·Critical Care Medicine·Nicholas S Hill
Feb 3, 2005·JAMA : the Journal of the American Medical Association·Vincenzo SquadroneUNKNOWN Piedmont Intensive Care Units Network (PICUN)

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Citations

Oct 17, 2012·Journal of Clinical Monitoring and Computing·Antonio M Esquinas, Güniz Koksal
Jun 9, 2009·Critical Care : the Official Journal of the Critical Care Forum·Onnen MoererPaolo Pelosi
Dec 17, 2014·The European Respiratory Journal·Lara PisaniStefano Nava
Sep 1, 2020·Therapeutic Advances in Respiratory Disease·Houman ArmirfarzanKay B Leissner
Sep 10, 2021·Critical Care : the Official Journal of the Critical Care Forum·Andrea CoppadoroGiacomo Bellani

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