{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:34:46Z","timestamp":1792553686405,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T00:00:00Z","timestamp":1559606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      This study assessed the effects of a new interface that combined CPAP 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O by using a helmet with high-flow nasal cannula (HFNC) at varying flows in healthy volunteers. Outcome measures included pharyngeal pressures, diaphragm kinetics, breathing frequency, the temperature inside the helmet, and comfort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      After baseline assessment during spontaneous breathing, HFNC was applied at flows of 30, 40, and 50 L\/min. Successively, the volunteers underwent helmet CPAP at 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O and CPAP + HFNC at flows of 30, 40, and 50 L\/min. We measured the variations of pharyngeal pressures at end-expiration and end-inspiration, referenced to spontaneous breathing for HFNC and to CPAP for CPAP + HFNC, diaphragm displacement and thickness at end-expiration and thickness at end-inspiration, breathing frequency, the temperature inside the helmet, the occurrence of the fog effect, and comfort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Variations of pharyngeal pressures at end-inspiration changes were small overall and clinically unimportant. With the mouth closed, at increasing HFNC flow, variations of pharyngeal pressures at end-expiration increased during both HFNC (from 2.8 up to 7.7) and, to a lesser extent, CPAP + HFNC (from 2.7 up to 3.8) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 for all comparisons). These variations were attenuated during open-mouth breathing. HFNC \u2265 40 L\/min and CPAP + HFNC \u2265 40 L\/min compared with spontaneous breathing and CPAP, respectively, increased diaphragm displacement (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), thickness at end-inspiration and thickness at end-expiration (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .003 for both). At all flows, breathing frequency was slightly, although significantly, lower with CPAP + HFNC than with HFNC alone (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .003). The temperature inside the helmet increased slightly and insignificantly at flows of \u226440 L\/min with CPAP + HFNC compared with CPAP alone. The fog effect never occurred, whereas comfort was always rated as optimal, without differences between trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>CPAP + HFNC was well tolerated, with no adverse effects. Based on our findings, there was no need to vary the CPAP level when adding HFNC. At least in healthy subjects, CPAP + HFNC at 30 L\/min seemed to be the best combination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.06871","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T13:09:01Z","timestamp":1559653741000},"page":"1231-1239","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Evaluation of a New Interface Combining High-Flow Nasal Cannula and CPAP"],"prefix":"10.1177","volume":"64","author":[{"given":"Eugenio","family":"Garofalo","sequence":"first","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bruni","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Pelaia","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmaria","family":"Cammarota","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care, \u201cMaggiore della Carit\u00e0\u201d Hospital, Novara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Murabito","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Biamonte","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Longhini","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Navalesi","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,6,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.11.010"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2007.08.001"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-011-2239-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.92.1.66"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.2.9032185"},{"issue":"11","key":"e_1_3_2_7_2","first-page":"651","article-title":"The use of helmets to deliver non-invasive continuous positive airway pressure in hypoxemic acute respiratory failure","volume":"74","author":"Bellani G","year":"2008","unstructured":"Bellani G, , Patroniti N, , Greco M, , Foti G, , Pesenti A. 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