The purpose of this study is to determine whether helmet is effective as device for noninvasive positive pressure ventilation in the weaning from mechanical ventilation.

The clinical efficacy of noninvasive positive pressure ventilation (NPPV) has been demonstrated. Interest has emerged in using NPPV to facilitate earlier removal of an endotracheal tube and decrease complications associated with prolonged intubation. Studies assessing NPPV in weaning are not enough and generally are performed with face masks as device for NPPV. This study assesses the efficacy of helmet as device for NPPV during weaning from mechanical ventilation in an ICU and compares this procedure with invasive mechanical complication (IMV) by analyzing respiratory parameters, clinical course and complications.

Inclusion Criteria:

• endotracheal mechanical ventilation for 48 hours or more for acute respiratory failure,
• patient ready to be weaned (steady respiratory and hemodynamic conditions for 24 hours),
• spontaneous breathing trial failure
• written informed consent obtained (patient or family)

Exclusion Criteria:

• respiratory and hemodynamic instability
• initial difficult intubation
• bronchial hypersecretion at the weaning time
• non cooperant patient
• recent history of upper gastro-intestinal surgery
• recent history of myocardial infarction