6 cmH<sub>2</sub>O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: A randomized trial

Milési, Christophe; Matecki, Stéfan; Jaber, Samir; Mura, Thibault; Jacquot, Aurélien; Pidoux, Odile; Chautemps, Nathalie; Novais, Aline Rideau Batista; Combes, Clémentine; Picaud, Jean‐Charles; Cambonie, Gilles

doi:10.1002/ppul.22533

Cited by 85 publications

(65 citation statements)

References 35 publications

(50 reference statements)

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“…Third, acute bronchiolitis leading to PICU admission occurs often in babies aged 1 to 4 months. [2][3][4][5] The median age of our population was higher because in Italy younger babies are often admitted to NICUs owing to a relatively low number of PICUs. 35 Our population also had more severe parenchymal disease than the classic RSV clinical presentation; the high percentage of bacterial coinfection may explain the more severe hypoxia we found.…”

Section: Discussionmentioning

confidence: 99%

“…1 In infants with severe RSV bronchiolitis, CPAP reduces the esophageal pressure time product, and 6 to 7 cm H 2 O CPAP was associated with the greatest muscle unloading, improvement in breathing pattern, and favorable clinical outcome. [2][3][4] In this series, all infants needing NRS were ,1 year old. Younger children cope less well with NRS than older ones, who are more cooperative.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Inflammation triggers the obstruction of small airways, resulting in reduced lung function and rapid, shallow breathing. 4 Up to 8% of infants with acute RSV bronchiolitis are admitted to a PICU needing noninvasive respiratory support (NRS) because of recurrent apnea or acute respiratory failure (ARF).…”

Section: Respiratory Syncytial Virus (Rsv)mentioning

confidence: 99%

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Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

et al. 2015

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BACKGROUND: Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF. METHODS:In this multicenter randomized controlled trial, 30 infants with respiratory syncytial virus-induced ARF were randomized to receive CPAP by helmet (n = 17) or facial mask (n = 13). The primary endpoint was treatment failure rate (defined as due to intolerance or need for intubation). Secondary outcomes were CPAP application time, number of patients requiring sedation, and complications with each interface.RESULTS: Compared with the facial mask, CPAP by helmet had a lower treatment failure rate due to intolerance (3/17 [17%] vs 7/13 [54%], P = .009), and fewer infants required sedation (6/17 [35%] vs 13/13 [100%], P = .023); the intubation rates were similar. In successfully treated patients, CPAP resulted in better gas exchange and breathing pattern with both interfaces. No major complications due to the interfaces occurred, but CPAP by mask had higher rates of cutaneous sores and leaks.CONCLUSIONS: These findings confirm that CPAP delivered by helmet is better tolerated than CPAP delivered by facial mask and requires less sedation. In addition, it is safe to use and free from adverse events, even in a prolonged clinical setting. WHAT'S KNOWN ON THIS SUBJECT:In a previous short-term physiologic randomized controlled trial, continuous positive airway pressure by helmet was feasible and efficient in improving gas exchange in pediatric acute respiratory failure due to bronchiolitis. WHAT THIS STUDY ADDS:Continuous positive airway pressure administered by helmet reduces the rate of noninvasive respiratory support failure and provides longer application time with less sedation than a facial mask. In addition, it is safe to use and free from adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

et al. 2015

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“…Early initiation of NIPPV on bronchiolitis patients needing it is important for improving patient outcomes [77]. If one can predict which bronchiolitis patients in the ED or general inpatient ward will need a specific type of NIPPV, admission could be directed to an inpatient unit that can deliver this type of NIPPV [76].…”

Section: Predicting the Use Of A Specific Type Of Nippvmentioning

confidence: 99%

A systematic review of predictive modeling for bronchiolitis

Luo

Nkoy

Gesteland

et al. 2014

International Journal of Medical Informatics

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Purpose: Bronchiolitis is the most common cause of illness leading to hospitalization in young children. At present, many bronchiolitis management decisions are made subjectively, leading to significant practice variation among hospitals and physicians caring for children with bronchiolitis. To standardize care for bronchiolitis, researchers have proposed various models to predict the disease course to help determine a proper management plan. This paper reviews the existing state of the art of predictive modeling for bronchiolitis. Predictive modeling for respiratory syncytial virus (RSV) infection is covered whenever appropriate, as RSV accounts for about 70% of bronchiolitis cases.Methods: A systematic review was conducted through a PubMed search up to April 25, 2014. The literature on predictive modeling for bronchiolitis was retrieved using a comprehensive search query, which was developed through an iterative process.Search results were limited to human subjects, the English language, and children (birth-18 years). Results:The literature search returned 2,312 references in total. After manual review, 168 of these references were determined to be relevant and are discussed in this paper. We identify several limitations and open problems in predictive modeling for bronchiolitis, and provide some preliminary thoughts on how to address them, with the hope to stimulate future research in this domain. Conclusions:Many problems remain open in predictive modeling for bronchiolitis. Future studies will need to address them to achieve optimal predictive models.

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“…Um estudo de coorte retrospectivo demonstrou que após a implementação do CPAP nasal como primeira estratégia de suporte ventilatório na BVA houve uma redução do custo anual de internação de 715.000 euros 15 . Um estudo realizado por Milési et al 16 comparou o uso do CPAP à 6cmH 2 O com oxigenoterapia convencional em crianças de até seis meses de idade, internadas em UTI pediátrica com diagnóstico clínico de BVA. Os pacientes que utilizaram CPAP obtiveram uma redução mais rápida do trabalho respiratório.…”

Section: Introductionunclassified

Ventilação mecânica não invasiva na bronquiolite viral aguda: estudo de coorte retrospectivo

et al. 2017

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6 cmH₂O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: A randomized trial

Abstract: nCPAP rapidly decreased inspiratory work in young infants with acute bronchiolitis. Improvement in the respiratory distress score at 6 hr was proportional to the initial clinical severity, suggesting the importance of rapid nCPAP initiation in the more severe forms of the disease.

Cited by 85 publications

References 35 publications

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

A systematic review of predictive modeling for bronchiolitis

Ventilação mecânica não invasiva na bronquiolite viral aguda: estudo de coorte retrospectivo

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6 cmH2O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: A randomized trial

Abstract: nCPAP rapidly decreased inspiratory work in young infants with acute bronchiolitis. Improvement in the respiratory distress score at 6 hr was proportional to the initial clinical severity, suggesting the importance of rapid nCPAP initiation in the more severe forms of the disease.

Cited by 85 publications

References 35 publications

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT

A systematic review of predictive modeling for bronchiolitis

Ventilação mecânica não invasiva na bronquiolite viral aguda: estudo de coorte retrospectivo

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6 cmH₂O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: A randomized trial