There is an Italian helmet that prevents intubation for serious Covid patients

There is an Italian helmet that prevents intubation for serious Covid patients

An Italian invention seems to reduce the need for invasive mechanical ventilation for patients affected by Covid-19 in severe form: it could have advantages in terms of mortality

(Image: Getty Images) It looks like a helmet from diver and also its function is more or less the same: to allow you to breathe. An Italian invention born before the emergence of the Sars-Cov-2 coronavirus as a possible alternative to other forms of non-invasive ventilation, and which found wider application during the pandemic. Almost exclusively in our country, however. Now a study in Jama magazine highlights the possible advantages for Covid patients: it seems to reduce the need to resort to intubation, an event that is associated with a high mortality rate (about 45%).

The study Henivot, which took place between October and December 2020, involved 109 Covid patients in various centers on the Peninsula, who arrived in intensive care due to acute respiratory failure. When requested for non-invasive respiratory support, 54 of them were given helmets, while the other 55 received high-flow oxygen therapy with nasal cannula (which today is the standard of treatment, also due to its easy management). >
(image: Grieco et al; Jama 2021) The comparison between the two systems (the first in the world with Covid patients) highlighted some differences, secondary outcomes of the study but clinically relevant: in the group of patients with helmets, a significantly lower incidence of the need for intubation was recorded compared to the traditional oxygen therapy group (30% vs 51%) in addition, the use of helmets has increased the number of days free from invasive mechanical ventilation to 28 days, which went from 25 to 28. An intriguing result, according to international experts, which deserves to be investigated further.

"The helmet is a different way to help patients, because it allows to deliver very high pressures that allow to 'reopen' the lung affected by the inflammatory process and reduce the respiratory fatigue of these patients", explained Domenico Luca Grieco, resuscitator at the Intensive Care Unit of the Columbus Covid2 Hospital-Agostino Gemelli Irccs University Polyclinic Foundation and head of the study. "In this work we compared the effects of high flow oxygen therapy with those of the helmet and the results show that the helmet avoids the use of invasive ventilation (intubation, ed) in about 40% more patients". The hypothesis is that the setup and the pressure conditions created inside the helmet allow a more effective alveolar recruitment, improving oxygenation and respiratory work.

Promising results, defined Grieco himself, considering also the fact that they were obtained in an emergency context. However, the optimal use of this system requires highly experienced personnel, which could slow down the adoption of the made in Italy helmet in international contexts.

The study, however, also has the merit of having highlighted the heterogeneous nature respiratory failure in the same pathological context. Continuing the experimentation could allow to identify the ideal target population, the one that would derive the maximum benefit from using the helmet.

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