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We evaluated whether NIV with helmet decreases the incidence of complications and improves its effects in a single center. Patients with ARF after chest trauma were randomized to receive NIV with helmet or face mask. The primary outcome was the rate of NIV-related complications. Secondary outcomes were PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>, patient\u2019s tolerance, intubation rate, length of intensive care unit (ICU) stay, and ICU mortality. The trial was terminated early after an interim analysis with 59 patients. The incidence of complications was lower in the helmet group [10% (3\/29) vs 43% (13\/30), <jats:italic>P<\/jats:italic>\u2009=\u20090.004], and PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>s were higher at 1\u00a0h and at the end of NIV (253.14\u2009\u00b1\u200964.74\u00a0mmHg vs 216.06\u2009\u00b1\u200943.86\u00a0mmHg, 277.07\u2009\u00b1\u200984.89\u00a0mmHg vs 225.81\u2009\u00b1\u200963.64\u00a0mmHg, <jats:italic>P<\/jats:italic>\u2009=\u20090.013 and 0.012) compared with them in face mask group. More patients reported excellent tolerance of the helmet vs face mask after 4\u00a0h of NIV [83% (24\/29) vs 47% (14\/30), <jats:italic>P<\/jats:italic>\u2009=\u20090.004] and at the end of NIV [69% (20\/29) vs 30% (9\/30), <jats:italic>P<\/jats:italic>\u2009=\u20090.03]. Differences in intubation rate, ICU stay, and mortality were non-significant (<jats:italic>P<\/jats:italic>\u2009=\u20090.612, 0.100, 1.000, respectively). NIV with helmet decreased NIV-related complications, increased PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>, and improved tolerance compared with NIV with face mask in patients with chest trauma.<\/jats:p><jats:p><jats:bold>Trial registration:<\/jats:bold> Registered in the Chinese Clinical Trial Registry (ChiCTR1900025915), a WHO International Clinical Trials Registry Platform (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\/searchprojen.aspx\">http:\/\/www.chictr.org.cn\/searchprojen.aspx<\/jats:ext-link>).<\/jats:p>","DOI":"10.1038\/s41598-020-78607-5","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T11:04:42Z","timestamp":1607425482000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Noninvasive ventilation with a helmet in patients with acute respiratory failure caused by chest trauma: a randomized controlled trial"],"prefix":"10.1038","volume":"10","author":[{"given":"Qi","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengtian","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianliang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongchang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"78607_CR1","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/s0300-9572(01)00475-0","volume":"52","author":"K Vidhani","year":"2002","unstructured":"Vidhani, K., Kause, J. & Parr, M. 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