Use of Helmet CPAP in COVID-19 - A practical review

Pulmonology. 2021 Sep-Oct;27(5):413-422. doi: 10.1016/j.pulmoe.2021.01.008. Epub 2021 Feb 1.


Helmet CPAP (H-CPAP) has been recommended in many guidelines as a noninvasive respiratory support during COVID-19 pandemic in many countries around the world. It has the least amount of particle dispersion and air contamination among all noninvasive devices and may mitigate the ICU bed shortage during a COVID surge as well as a decreased need for intubation/mechanical ventilation. It can be attached to many oxygen delivery sources. The MaxVenturi setup is preferred as it allows for natural humidification, low noise burden, and easy transition to HFNC during breaks and it is the recommended transport set-up. The patients can safely be proned with the helmet. It can also be used to wean the patients from invasive mechanical ventilation. Our article reviews in depth the pathophysiology of COVID-19 ARDS, provides rationale of using H-CPAP, suggests a respiratory failure algorithm, guides through its setup and discusses the issues and concerns around using it.

Keywords: ARDS; COVID-19; Helmet; Non-invasive mechanical ventilation; Respiratory failure.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / physiopathology
  • COVID-19 / therapy*
  • COVID-19 / transmission
  • Continuous Positive Airway Pressure / instrumentation*
  • Head Protective Devices
  • Humans
  • Noninvasive Ventilation / instrumentation*
  • Noninvasive Ventilation / methods
  • Oxygen Inhalation Therapy / instrumentation
  • Oxygen Inhalation Therapy / methods
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / nursing
  • Respiratory Insufficiency / therapy*
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification
  • Ventilator Weaning / methods*