Under the present experimental conditions, the use of a helmet increased LOS and the duration of artificial ventilation. Conclusions: In patients with acute exacerbation of COPD and undergoing NPPV, the sequential use of a mask and helmet diminished the incidence of failure. Time of noninvasive ventilation and LOS were lower in the mask than in the helmet group. Nine patients in the mask group and 2 in the helmet group failed NPPV, 8 and 1, respectively, owing to intolerance. Four hours after randomization, PaCO 2 was lower in the mask group than in the helmet group.

Results: After the first 2 h of NPPV, gas exchange and clinical parameters improved in 40 patients. Need for intubation, ventilatory assistance, length of stay (LOS) and complications were recorded. Available exclusively through Limited Run Games, the Dead Space Collector’s Edition will retail for 274.99 and includes a wealth of physical goodies, including a wearable replica of protagonist. If gas exchange and clinical status improved, they were randomized to continue on NPPV by mask or helmet.Physiological parameters were measured at admission, after the first 2 h on NPPV by mask, 4 h after randomization and at discharge. Methods: Fifty-three patients ventilated for the first 2 h with NPPV by mask were studied. Objective: To evaluate the sequential use of mask and helmet during NPPV in patients with severe exacerbation of COPD in order to reduce the intolerance to these devices. A high incidence of intolerance limits the use of this approach. Background: Noninvasive positive pressure ventilation (NPPV) using a face mask is the ventilatory mode of choice in selected patients experiencing acute exacerbation of chronic obstructive pulmonary disease (COPD).

Dead space Criterion Helmet