PT - JOURNAL ARTICLE AU - Lara Pisani AU - Chiara Mega AU - Rosanna Vaschetto AU - Andrea Bellone AU - Raffaele Scala AU - Roberto Cosentini AU - Muriel Musti AU - Manuela Del Forno AU - Mario Grassi AU - Luca Fasano AU - Paolo Navalesi AU - Stefano Nava TI - Oronasal mask <em>versus</em> helmet in acute hypercapnic respiratory failure AID - 10.1183/09031936.00053814 DP - 2015 Mar 01 TA - European Respiratory Journal PG - 691--699 VI - 45 IP - 3 4099 - http://erj.ersjournals.com/content/45/3/691.short 4100 - http://erj.ersjournals.com/content/45/3/691.full SO - Eur Respir J2015 Mar 01; 45 AB - The choice of the interface for noninvasive ventilation (NIV) is a key factor in NIV success. We hypothesised that a new helmet specifically design to improve performance in hypercapnic patients would be clinically equivalent to a standard oronasal mask. In a multicentre, short-term, physiological, randomised trial in chronic obstructive pulmonary disease patients facing an acute hypercapnic respiratory failure episode, we compared the changes in arterial blood gases (ABGs) and tolerance score obtained using the helmet or mask, and, as secondary end-points, dyspnoea, vital signs, early NIV discontinuation and rate of intubation. 80 patients were randomly assigned to receive NIV either with the helmet (n=39) or mask (n=41), using an intensive care unit ventilator. Compared with baseline, in the first 6 h, NIV improved ABGs, dyspnoea and respiratory rate (p&lt;0.05) in both groups. Changes in ABGs and discomfort were similar with the two groups, while dyspnoea decreased more (p&lt;0.005) using the mask. The rate of intubation and the need for interface change during the whole period of NIV were very low and not different between groups. The new helmet may be a valid alternative to a mask in improving ABGs and achieving a good tolerance during an episode of acute hypercapnic respiratory failure. In COPD patients undergoing NIV, an oronasal mask and a helmet equally improved ABGs and tolerance score http://ow.ly/DMVIg