title: [The comfort of patients ventilated with the Helmet Bundle].
abstract: BACKGROUND
  Interventions aimed at increasing comfort of patients treated with Helmet Continuous Positive Airway Pressure (H-CPAP) increase its endurance and the duration of treatment.
  
  
  OBJECTIVE
  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 degrees 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.
authors.affiliation: Terapia Intensiva Generale A.O. S. Gerardo, Università Milano-Bicocca, Monza.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lucchini
authors.forename: Daria
authors.initials: D
authors.lastname: Valsecchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Elli
authors.forename: Valentina
authors.initials: V
authors.lastname: Doni
authors.forename: Petronilla
authors.initials: P
authors.lastname: Corsaro
authors.forename: Pancrazio
authors.initials: P
authors.lastname: Tundo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Re
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Foti
authors.forename: Matteo
authors.initials: M
authors.lastname: Manici
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006260:Head Protective Devices; D006801:Humans; D006813:Humidity; D009622:Noise / Q000517:prevention & control; D010146:Pain / Q000209:etiology / Q000517:prevention & control