Noninvasive pressure-support ventilation in immunocompromised children with ARDS: a feasibility study

Piastra, Marco; Luca, Danièle De; Pietrini, Domenico; Pulitanò, Silvia; D’Arrigo, Sonia; Mancino, Aldo; Conti, Giorgio

doi:10.1007/s00134-009-1558-5

Cited by 89 publications

(82 citation statements)

References 19 publications

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“…The helmet is supposed to have several advantages over nasal or whole-face masks: it allows free movement of the infant's head as well as a good interaction with the environment while maintaining a good seal without compression. [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.…”

Section: Discussionmentioning

confidence: 99%

“…[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: 99%

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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“…The study results encourage the use of NIV as the first treatment in oncologic children with respiratory insufficiency, and without hemodynamic instability (19) . Piastra et al (22) developed a prospective cohort study with 23 immunocompromised patients with ARDS admitted to the ICU of a university hospital and treated with NIV. There was no difference in the scores of severity between the NIV responders and non-responders.…”

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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“…El casco o helmet viene empleándose de forma creciente y exitosa en los últimos años en pacientes adultos 8,9 , si bien es una de las menos conocidas, con escasas referencias en la literatura sobre pacientes pediátricos. En los estudios realizados hasta la fecha en lactantes y niños no se han descrito efectos secundarios derivados del uso de CPAP a través de un sistema helmet 10,11 , a excepción de dolor axilar en 2 pacientes inmunodeprimidos con síndrome de distrés respiratorio agudo 12 . Un estudio que compara el helmet con la mascarilla facial en pacientes pediátricos con insuficiencia respiratoria aguda refiere mejor tolerancia y menor número de lesiones por presión y de fugas aéreas empleando el helmet 13 .…”

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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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Noninvasive pressure-support ventilation in immunocompromised children with ARDS: a feasibility study

Cited by 89 publications

References 19 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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