Tidal volume and helmet: Is the never ending story coming to an end?

Noninvasive ventilation (NIV) has been increasingly used in acute care setting with various indications, but its use in patients with acute hypoxemic respiratory failure (AHRF) is controversial. In this setting, reliable monitoring of Vt and unintentional leaks is of the utmost importance. The aim of this article is to describe the importance of tidal volume measurement in the context of AHRF treated with NIV.