Helmet Ventilation in Acute Hypercapnic Respiratory Failure

Hypercapnic Acute Respiratory Failure: Is the Helmet an Effective Interface?"

Lack of tolerance to the treatment, makes the interface choice for non-invasive ventilation (NIV) one of the key factor. To date the helmet is rarely used in Acute Hypercapnic Respiratory Failure (AHRF), because of its large dead space, despite in hypoxic respiratory failure, it is largely employed as a "rotating" strategy when the facial mask is poorly tolerated.

In a multicenter randomized controlled trial, the investigators will compare the clinical efficacy of a new helmet designed to specifically improve the performance in chronic obstructive pulmonary disease (COPD) versus a full face mask during an episode of AHRF.

Inclusion Criteria:

• pH < 7,35 and PaCO2 > 45 mmHg
• respiratory rate > 20 b/min

Exclusion Criteria:

• hypoxic respiratory failure
• coma
• inability to stand NIV
• lack of informed consent