The comfort of patients ventilated with the helmet bundle [The helmet bundle: Il comfort del paziente ventilato con CPAP con scafandro]

Introduction. Interventions aimed at increasing comfort of patients treated with Helmet Continuous Positive Airway Pressure (H-CPAP) increase its endurance and the duration of treatment. Aim. To assess the effect of nursing interventions on factors of discomfort for H-CPAP patients. Methods. The fixing method of the helmet (5 subjects), the noise generated by the gas source and the level of humidity in the helmet were assessed. Fixing method: pain measured with Numeric rating scales (NRS) and Stress detector after the application of armpit straps or counterweights. Noise: level of noise (decibel measurement) in the helmet and the interventions to reduce it. Humidity: level of humidity with different models of active humidifiers. Results. The armpit straps increase the pain measured with the stress detector of 0.206 microSiemens and of 4.8 points of the NRS after 5 minutes. The system with counterweights does not increase pain. The Heath and Moisture Exchangers (HME) Filters and tubes with smooth inner surface decrease the level of noise in the helmet from 70 to 48 decibel, with a gas flow of 30 l/min. The humidification and warming of gases (26°C (-2 gradient) and warmed tubes) delivers a relative humidity of 33.9±1.9 mgH2O/l thus avoinding the steaming of the helmet. Conclusions. The use of counterweights, HME filters, tubes with smooth surface, ear plugs to reduce the noise level and active humidification and warming of gases reduce the discomfort associated to H-CPAP.