A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system

Abstract

In this short-term physiological study the neonatal helmet CPAP appears to be as good as the golden standard for managing preterm infants needing continuous distending pressure, with enhanced tolerability. Further evaluation in a randomized clinical trial is needed to confirm these findings.

Hydrocolloid dressing in preventing nasal trauma secondary to nasal continuous positive airway pressure in preterm infants

“…[2][3][4] Kattwinkel et al [13] first described the initial experience using short bi-nasal prongs to deliver CPAP in a small case series of infants supported using nasal prongs and a T-piece CPAP system, similar to that reported by Gregory et al That 82% never required any other form of support, including mechanical ventilation. Although various devices had been developed to deliver continuous positive airway pressure such as nasopharyngeal tube, different prong systems and mask CPAP, the bi-nasal prongs have been most widely used in the respiratory management of neonates.…”

“…Although various devices had been developed to deliver continuous positive airway pressure such as nasopharyngeal tube, different prong systems and mask CPAP, the bi-nasal prongs have been most widely used in the respiratory management of neonates. [4] Nasal injury was the common complication of continuous positive airway pressure. Robertson et al [6] found that the flow driver of continuous positive airway pressure could result in snubbing of the nose, fl aring of the nostrils, and necrosis of the columella nasi, and that the total incidence of nasal trauma with nasal prong was 20% in a group of VLBW infants.…”

“…[1,2] A nasal prong is the most commonly used for delivering CPAP because it is less invasive. [3,4] However, nasal trauma is a well documented complication of noninvasive respiratory support. [5,6] The local pressure of nasal prongs to the nasal region is easy to cause nasal injury in the newborn due to the cutaneous vulnerability.…”

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

“…[19][20][21][22][23] In preterm infants with mild respiratory distress, CPAP by helmet resulted in better tolerance and less oxygen desaturation than use of nasal prongs. 17 In preschool children with ARF of mixed etiologies, CPAP by helmet was safe and well tolerated and resulted in an early increase in oxygenation. 18 CPAP by helmet was also effective and well tolerated in hypoxemic children with parenchymal disease and in infants with RSV bronchiolitis, with less need for sedation and longer application time.…”

“…[12][13][14][15][16] A pediatric helmet has been used to deliver CPAP in neonates, infants, and preschool children with ARF. [17][18][19][20][21][22][23] In this population, CPAP by helmet was better tolerated than a facial mask, with no major complications and less need for sedation. [21][22][23] The aim of this prospective multicenter randomized controlled trial (RCT) was to compare the failure rates of helmet and facial mask CPAP in infants admitted to a PICU for RSVrelated ARF.…”