Lucchini Alberto, Valsecchi Daria, Elli Stefano, Doni Valentina, Corsaro Petronilla, Tundo Pancrazio, Re Riccardo, Foti Giuseppe, Manici Matteo
Terapia Intensiva Generale A.O. S. Gerardo, Università Milano-Bicocca, Monza.
Assist Inferm Ric. 2010 Oct-Dec;29(4):174-83.
Interventions aimed at increasing comfort of patients treated with Helmet Continuous Positive Airway Pressure (H-CPAP) increase its endurance and the duration of treatment.
To assess the effect of nursing interventions on factors of discomfort for H-CPAP patients.
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.
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.
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.
旨在提高使用头盔式持续气道正压通气（H-CPAP）治疗患者舒适度的干预措施可提高其耐受性和治疗持续时间。
评估护理干预对H-CPAP患者不适因素的影响。
评估头盔的固定方法（5名受试者）、气源产生的噪音以及头盔内的湿度水平。固定方法：应用腋带或配重后，用数字评分量表（NRS）和压力探测器测量疼痛。噪音：头盔内的噪音水平（分贝测量）以及降低噪音的干预措施。湿度：不同型号的主动加湿器的湿度水平。
使用腋带5分钟后，压力探测器测得的疼痛增加0.206微西门子，NRS评分增加4.8分。使用配重的系统不会增加疼痛。热湿交换器（HME）过滤器和内表面光滑的管道可将头盔内的噪音水平从70分贝降低到48分贝，气体流量为30升/分钟。气体的加湿和加热（26摄氏度（-2梯度）和加热管道）可提供33.9±1.9毫克水/升的相对湿度，从而避免头盔产生水汽。
使用配重、HME过滤器、表面光滑的管道、耳塞以降低噪音水平以及对气体进行主动加湿和加热可减少与H-CPAP相关的不适。
