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<h2 class="element-invisible">You are here</h2><div class="breadcrumb"><a href="/">Home</a> » <a href="/news-events">News & Events</a> » <a href="/news-events/nih-research-matters">NIH Research Matters</a></div> <div class="l-region l-region--section-header">
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<div about="/news-events/nih-research-matters/helmet-based-ventilation-eases-respiratory-distress" typeof="sioc:Item foaf:Document" class="ds-1col node node--nih-research-matters view-mode-full node--full node--nih-research-matters--full clearfix">
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<p class="publishdate"><span property="dc:date" datatype="xsd:dateTime" content="2016-05-24T00:00:00-04:00" class="date-display-single">May 24, 2016</span></p><div class='syndicate'><h1>Helmet-based ventilation eases respiratory distress</h1><div class="callout callout-with-border"><h3>At a Glance</h3>
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<li>Researchers compared noninvasive oxygen delivery methods—a helmet versus a face mask—for patients with acute respiratory distress syndrome.</li>
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<li>The trial was stopped early because the helmets proved more effective than the face masks for treating this condition. </li>
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<picture title="Helmet-based ventilation eases respiratory distress">
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<!--[if IE 9]><video style="display: none;"><![endif]-->
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-large/public/news-events/research-matters/2016/20160524-respiratory.jpg?itok=zo6Bw2lC&timestamp=1464030316 1x" media="screen and (min-width: 960px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2016/20160524-respiratory.jpg?itok=8bCP8gYP&timestamp=1464030316 1x" media="screen and (min-width: 800px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium-small/public/news-events/research-matters/2016/20160524-respiratory.jpg?itok=HjEzZZ8s&timestamp=1464030316 1x" media="screen and (min-width: 600px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-small/public/news-events/research-matters/2016/20160524-respiratory.jpg?itok=AiK5_8v1&timestamp=1464030316 1x" media="screen and (min-width: 480px)" />
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<source srcset="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-tiny/public/news-events/research-matters/2016/20160524-respiratory.jpg?itok=SdvtanTn&timestamp=1464030316 1x" media="screen and (min-width: 0)" />
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<!--[if IE 9]></video><![endif]-->
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<img src="https://www.nih.gov/sites/default/files/styles/floated_media_breakpoint-medium/public/news-events/research-matters/2016/20160524-respiratory.jpg?itok=8bCP8gYP&timestamp=1464030316" alt="Man in ventilation helmet" title="Helmet-based ventilation eases respiratory distress" />
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</picture><span class="caption">The noninvasive ventilation helmet is a transparent hood that covers the entire head of the patient and has a rubber collar neck seal.</span><span class="credit">The University of Chicago Medicine</span></div>
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</div><p>Acute respiratory distress syndrome (ARDS) is a life-threatening condition that occurs when fluid builds up in your lungs. The fluid blocks oxygen from entering your bloodstream and circulating to your body’s organs. If you don’t receive enough oxygen, your organs can’t function properly.</p>
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<p>ARDS can be treated with noninvasive ventilation methods—for example, through a mask that fits over your mouth and nose. But many patients with ARDS aren’t helped by face mask ventilation and require a more invasive procedure called intubation, in which a breathing tube is inserted through the mouth or nose and into the windpipe. The tube is connected to a ventilator that pumps oxygen-rich air into the lungs. Intubated patients are usually sedated and bedridden. The process can cause discomfort and other problems, including muscle deterioration and mental confusion.</p>
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<p>To investigate whether noninvasive ventilation using a helmet may be more effective than with a face mask, a team of scientists from the University of Chicago led by Dr. John P. Kress conducted a randomized clinical trial of patients with ARDS. The research was funded in part by NIH’s National Heart, Lung, and Blood Institute. Results were published online in the <em>Journal of the American Medical Association</em> on May 15, 2016.</p>
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<p>Researchers screened patients admitted to the intensive care unit. Those with ARDS who needed ventilation via a face mask for at least 8 hours were eligible to enroll in the study. A total of 83 patients (median age 59 years) were selected and randomly assigned to either continue receiving ventilation with a face mask (39 patients) or switch to a latex-free helmet (44 patients). Doctors delivered ventilation to both groups according to a standard protocol until oxygen levels reached above 90%. Patients were intubated if they had persistent or worsening respiratory failure, an intolerance for the face mask or helmet, neurologic deterioration, airway bleeding, or excessive respiratory secretions.</p>
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||
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<p>Intubation was necessary for 24 of the patients wearing a face mask (62%), but for only 8 of those with a helmet (18%). Patients with helmets also had more ventilator-free days on average (28 vs. 12.5) and spent significantly less time in the intensive care unit (4.7 day median vs. 7.8). The helmet group had 15 patient deaths (34%) over the 90 days following treatment randomization, compared to 22 deaths (56%) in the face mask group.</p>
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<p>“In this group of critically ill patients, the helmet made a substantial difference,” Kress says. “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.”</p>
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<p>Multicenter trials will be needed to confirm these results and standardize the procedures before the helmet could be used routinely in intensive care units. In addition, the helmet’s benefits need to be compared with another technique called high-flow nasal cannula treatment, which uses nasal prongs to deliver oxygen.</p>
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<p>—by Tianna Hicklin, Ph.D.</p>
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</div><h2 class="label-above">Related Links</h2><ul class="spaced print-urls"><li><a href="https://www.nhlbi.nih.gov/health/health-topics/topics/ards/" target="_top">Acute Respiratory Distress Syndrome (ARDS)</a></li><li><a href="http://www.nhlbi.nih.gov/health/health-topics/topics/vent/" target="_top">What Is a Ventilator?</a></li><li><a href="http://www.nhlbi.nih.gov/health/health-topics/topics/rf" target="_top">Respiratory Failure</a></li><li><a href="https://www.nia.nih.gov/health/publication/understanding-lung-problems" target="_top">Understanding Lung Problems</a></li></ul><p class="footnote"><strong class="label-inline">References: </strong><a href="http://www.ncbi.nlm.nih.gov/pubmed/27179847">Effect of Noninvasive Ventilation Delivered by Helmet vs Face Mask on the Rate of Endotracheal Intubation in Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.</a> Patel BK, Wolfe KS, Pohlman AS, Hall JB, Kress JP. <em>JAMA</em>. 2016 May 15. doi: 10.1001/jama.2016.6338. [Epub ahead of print]. PMID: 27179847.</p><p class="footnote"><strong class="label-inline">Funding: </strong>NIH’s National Heart, Lung, and Blood Institute (NHLBI); and the Daniel J. Edelman family.</p>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/research-context-detecting-cancer">Research in Context: Detecting cancer</a></p>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/risk-future-burden-dementia-united-states">Risk and future burden of dementia in the United States </a></p>
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<p><a href="https://www.nih.gov/news-events/nih-research-matters/complete-wiring-map-adult-fruit-fly-brain">Complete wiring map of an adult fruit fly brain</a></p>
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<h3 class="block__title">About NIH Research Matters</h3>
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<p><strong>Editor:</strong> Harrison Wein, Ph.D.</p>
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<p><strong>Assistant Editors:</strong> Vicki Contie and Brian Doctrow, Ph.D.</p>
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<p><strong><em>NIH Research Matters </em></strong>is a weekly update of NIH research highlights reviewed by NIH’s experts. It's published by the <a href="/institutes-nih/nih-office-director/office-communications-public-liaison">Office of Communications and Public Liaison</a> in the <a href="/institutes-nih/nih-office-director">NIH Office of the Director</a>.</p>
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<p>ISSN 2375-9593</p>
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