Continuous positive airway pressure with modified helmet for treatment of hypoxemic acute respiratory failure in infants and a preschool population: A feasibility study*

Codazzi, Daniela; Nacoti, Mirco; Passoni, M; Bonanomi, Ezio; Sperti, Lidia Rota; Fumagalli, Roberto

doi:10.1097/01.pcc.0000235246.68050.3a

Cited by 52 publications

(40 citation statements)

References 25 publications

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“…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. [21][22][23] Evaluation of comfort in infants during NRS is not standardized and, to our knowledge, no specifically designed score has yet been published.…”

Section: Discussionmentioning

confidence: 98%

“…[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.…”

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: 98%

Section: Respiratory Syncytial Virus (Rsv)mentioning

confidence: 99%

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

et al. 2015

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“…None of them experienced complications. Oxygenation improved after two hours of NIV, and no hemodynamic variation was detected (21) . The efficacy of NIV was evaluated in an Italian Intensive Care Unit (ICU) with 24 beds, during two years, analyzing pH, CO2, SatO2, respiratory rate, and need for oxygen.…”

Section: Stregth Of Recommendationmentioning

confidence: 99%

“…Codazzi et al (21) Case series (15) 2006 Fifteen children from 1 month to 5 years with hypoxemic ARF Piastra et al hypoxic group and hypercapnic group. Of these 20 patients, 15 displayed an improvement in oxygenation and ventilation; five required invasive mechanical ventilation; and two experienced pressure ulcers on nasal bridges, which were rapidly reversible (20) .…”

Section: Stregth Of Recommendationmentioning

confidence: 99%

Noninvasive ventilation for acute respiratory failure in children – a systematic review

Gonzaga

Silva

Alonso

et al. 2011

Einstein (São Paulo)

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Objective: To assess the role of noninvasive ventilation in the treatment of children with acute respiratory failure. Methods: A systematic review of literature on noninvasive ventilation in MEDLINE, LILACS, EMBASE, and Cochrane databases, besides references in articles. The outcomes evaluated were responses in blood oxygenation and ventilation, and patient survival. Results: A total of 120 studies on noninvasive ventilation were found as of May, 2010. Of these, only 19 were about noninvasive ventilation in children. On the other hand, there are prospective and cohort clinical trials leading to a level II quality of evidence concerning the use of noninvasive ventilation in children. Conclusion: There is scientific evidence for proposing the use of noninvasive ventilation, with a B-II degree of recommendation. Keywords

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“…Además, se evitarían las lesiones en la mucosa nasal 16 que podrían obligar a suspender la técnica e intubar al niño en determinados casos. En comparación con el uso de mascarilla nasal o buconasal, la ausencia de fugas debidas a la dificultad para la correcta adaptación de dichas interfases a la cara de los niños más pequeños, el empleo del helmet conlleva menor aparición de lesiones faciales por decúbito y conjuntivitis 17 ,l oq u e podría suponer que el paciente lo tolere mejor 10 . Otra ventaja que ofrece el helmet es que permite un alto grado de humidificación 18 , lo cual favorece que no haya obstrucción por secreciones y permite mantener contacto visual continuo con el paciente.…”

Section: Ventajas E Inconvenientesunclassified

Montaje y manejo del sistema helmet-CPAP en lactantes y niños con insuficiencia respiratoria aguda

González

Mayordomo-Colunga

Galán

et al. 2011

Enfermería Intensiva

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Continuous positive airway pressure with modified helmet for treatment of hypoxemic acute respiratory failure in infants and a preschool population: A feasibility study*

Abstract: The helmet is a suitable device for delivery of CPAP to infants and preschool children with hypoxemic acute respiratory failure. It was well tolerated and improved oxygenation.

Cited by 52 publications

References 25 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

Noninvasive ventilation for acute respiratory failure in children – a systematic review

Montaje y manejo del sistema helmet-CPAP en lactantes y niños con insuficiencia respiratoria aguda

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