Does helmet CPAP reduce cerebral blood flow and volume by comparison with Infant Flow driver CPAP in preterm neonates?

Abstract

Assessing CBF and DeltaCBV measured by near-infrared spectroscopy with two CPAP devices revealed no differences in relative blood volume, but CBF was lower with helmet CPAP. Greater active vasoconstriction and/or passive capillary and/or venous vessel compression seem the most likely reason, due to a positive pressure around the head, neck, and shoulders by comparison with the airway pressure.

An Integrative Review of Skin Breakdown in the Preterm Infant Associated with Nasal Continuous Positive Airway Pressure

“…Of special interest is the development of alternative devices to provide CPAP to neonates without placing pressure on the nares, a stated negative consequence of the therapy. Alternative CPAP methods whose design correlates to an early plastic pressure chamber device developed by Gregory and others in the 1970s, made a recent comeback with helmet CPAP devices to provide PEEP to the neonate while sparing nasal surfaces (Chidini et al., ; Trevisanuto et al., ; Zaramella et al., ). These methods are currently experimental without widespread application.…”

The SafeBoosC Phase II Randomised Clinical Trial: A Treatment Guideline for Targeted Near-Infrared-Derived Cerebral Tissue Oxygenation versus Standard Treatment in Extremely Preterm Infants

“…The effect of the type of mechanical ventilation or airway pressure on the cerebral haemodynamics and oxygenation by NIRS has been the focus of some small observational studies in newborns [71,72,73,74,75]. The way these different methods affect intrathoracic pressures would likely impact the cerebral and systemic circulation of immature neonates [76].…”

Pharyngeal pressure value using two continuous positive airway pressure devices

“…Zaramella et al 7 assessed cerebral blood flow and relative changes in cerebral blood volume in infants treated with hood CPAP and nCPAP and found no differences in relative blood volume, although cerebral blood flow was lower during hood CPAP. No difference in occurrence of brain lesions was observed.…”