Noninvasive ventilation (NIV) has been widely used to decrease the complications associated with tracheal intubation in mechanically ventilated patients with neuromuscular diseases in acute respiratory failure. However, nasal ulcerations might occur when masks are used as an interface. Helmet ventilation is a possible option in this case. We describe two patients with acute respiratory failure due to Duchenne muscular dystrophy who developed nasal bridge skin necrosis during NIV. Helmet pressure support ventilation caused significant patient-ventilator asynchrony, leading to NIV intolerance. Thus, biphasic positive airway pressure delivered by helmet was applied, which improved gas exchange and patient-ventilator interaction, allowing successful NIV
RACCA F., APPENDINI L., BERTA L., VITTONE F., GREGORETTI C., FERREYRA G., et al. (2009). HELMET VENTILATION FOR ACUTE RESPIRATORY FAILURE AND NASAL SKIN BREAKDOWN IN NEUROMUSCULAR DISORDERS. ANESTHESIA AND ANALGESIA, JUL; 109(1), 164-167 [10.1213/ane.0b013e3181a1f708].
HELMET VENTILATION FOR ACUTE RESPIRATORY FAILURE AND NASAL SKIN BREAKDOWN IN NEUROMUSCULAR DISORDERS
RANIERI V.M.
2009
Abstract
Noninvasive ventilation (NIV) has been widely used to decrease the complications associated with tracheal intubation in mechanically ventilated patients with neuromuscular diseases in acute respiratory failure. However, nasal ulcerations might occur when masks are used as an interface. Helmet ventilation is a possible option in this case. We describe two patients with acute respiratory failure due to Duchenne muscular dystrophy who developed nasal bridge skin necrosis during NIV. Helmet pressure support ventilation caused significant patient-ventilator asynchrony, leading to NIV intolerance. Thus, biphasic positive airway pressure delivered by helmet was applied, which improved gas exchange and patient-ventilator interaction, allowing successful NIVI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
