W.J. Randerath, J. Meier, H. Genger, U. Domanski, K‐H. Rühle

Ano: 01 de julho de 2020
DOI: 10.1183/09031936.02.00267902




Helmet CPAP (H-CPAP) has been recommended in many guidelines as a noninvasive
respiratory support during COVID-19 pandemic in many countries around the world. It has
the least amount of particle dispersion and air contamination among all noninvasive devices
and may mitigate the ICU bed shortage during a COVID surge as well as a decreased need for
intubation/mechanical ventilation. It can be attached to many oxygen delivery sources. The
MaxVenturi setup is preferred as it allows for natural humidification, low noise burden, and
easy transition to HFNC during breaks and it is the recommended transport set-up. The patients
can safely be proned with the helmet. It can also be used to wean the patients from invasive
mechanical ventilation. Our article reviews in depth the pathophysiology of COVID-19 ARDS,
provides rationale of using H-CPAP, suggests a respiratory failure algorithm, guides through its
setup and discusses the issues and concerns around using it.