SESSION TITLE: Respiratory Failure SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: For patients with selected etiologies of respiratory failure, non-invasive ventilation may be an important option to prevent intubation and mechanical ventilation, or post-extubation failure. Recent studies (Patel, et al., JAMA 2016) suggested that a helmet interface for NIPPV is better tolerated with better clinical outcomes than a mask interface. Helmet NIPPV is rarely used in the US. We describe our own experience with a helmet interface prior to clinical use. METHODS: Users wore a helmet or a mask for non-invasive positive pressure. NIPPV was delivered by an AVEA ventilator in the PSV mode via a Helmet, or a non-vented full face mask. During and after at least 10 minutes of NIPPV, users scored their subjective experience of several variables on a 0-10 visual analog scale (VAS), where 0 is intolerable and 10 is equivalent to breathing without an interface. Items of interest included: comfort, claustrophobia, noise, temperature, pressure related discomfort (ears, eyes and airway), and ease of triggering inspiration and expiration. RESULTS: Evaluations by VAS scores were completed by 2 female and 3 male healthy clinicians; height range 58-73 inches, and neck size 14 - 16 inches. All completed more than 30 minutes of helmet ventilation and 10 minutes of mask ventilation. At all pressures, all clinicians reported better VAS scores for overall comfort with a helmet than with a mask (8.2±1.1 vs. 4.8±1.5 mask). The helmet was subjectively better for several items scored. The VAS scores for helmet included: claustrophobia (9.6±0.5 vs. 7.2±1.1 mask), noise (8.6±0.9 vs. 7.8±2.3 mask), temperature (7.4±1.9 vs. 8.2±1.9 mask), eye pressure (9.2±1.1 vs. 8.4±2.1 mask), and ear pressure (6.6±1.8 vs. 8.6±1.1 mask). Users reported better tolerance to the helmet for PEEP up to 10 cm H2O and inspiratory pressure up to 15 cm H2O (8.0±0.9 vs. 4.9±1.5 mask). Users noted better inspiratory synchrony with the helmet (8.4±0.8 vs 6.0±2.0 mask), better anticipated long-term tolerance (8.8±1.6 vs. 3.8±1.5 mask) and ability to communicate by speaking (9.0±1.0 vs. 1.4±0.5 mask). CONCLUSIONS: Healthy volunteers rated the helmet for delivery of NIPPV as more comfortable and better tolerated than a full face mask. Notable subjective complaints with mask NIPPV were: pressure on the face, and inability to communicate be speaking. Discomforts of the Helmet were, at high applied pressures, inner ear pressure and anterior neck pressure. Inspiratory and Expiratory triggering were better with the helmet, particularly at higher pressures. CLINICAL IMPLICATIONS: Application of NIPPV via a helmet interface was better tolerated than via a mask in normal persons. Our observations are consistent with prior descriptions and suggest specific reasons for better tolerance of the Helmet. These data support a possible role of the helmet interface with NIPPV in patients with respiratory failure. DISCLOSURE: The following authors have nothing to disclose: Bogdan Tiru, Mihaela Stefan, Mark Tidswell, Lucienne Lutfy-Clayton, Christopher Frechette, Jay Steingrub, Nicholas Hill No Product/Research Disclosure Information