Noninvasive Continuous Positive Airway Pressure in Acute Respiratory Failure: Helmet Versus Facial Mask

Chidini, Giovanna; Calderini, Edoardo; Cesana, Bruno Mario; Gandini, C.; Prandi, Edi; Pelosi, Paolo

doi:10.1542/peds.2009-3357

Cited by 36 publications

(46 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…No depressurization has been detected during treatment with a helmet, according to previous reports. [23][24][25][26][27] The pediatric helmet was introduced in clinical practice to increase the infant's comfort while on CPAP. 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.…”

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%

“…23 CPAP was maintained by a generator able to deliver gas flow up to 140 L/minute and an underwater bubbling valve. The pediatric helmet (Castar Starmed, Mirandola, Italy) has a 27-cm collar diameter and 6-L internal volume.…”

Section: Cpapmentioning

confidence: 99%

“…High fresh-gas flow (.35 L/minute) was used to avoid CO 2 rebreathing. 21,23,[25][26][27] All patients were kept in a semirecumbent position. In all centers, a standard oronasal mask (Profile Lite Gel size XS-S, Respironics, Murrysville, PA) was used, and its size was chosen to fit the face as well as possible.…”

Section: Cpapmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2015

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Respiratory Syncytial Virus (Rsv)mentioning

confidence: 99%

Section: Cpapmentioning

confidence: 99%

Section: Cpapmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, pediatric application of NIV has been limited by the lack of availability of these interfaces. This has led to the need for custom fitted masks [1], nonconventional interfaces such as helmets [2,3], or failure of this approach to ventilatory support when such masks are unavailable. These issues are compounded by the fact that because of the more diverse population, infrequent mortality, and shorter duration of mechanical ventilation, fewer randomized controlled trials (RCTs) are available in pediatric patients than adults [4].…”

Section: Introductionmentioning

confidence: 99%

Advances in Ventilatory Support of Critically Ill Children

Chipman

Kacmarek

2012

Curr Pediatr Rep

View full text Add to dashboard Cite

Advances in pediatric medical practices often lag behind the progress made in adult patients, primarily because of the limited number of randomized, controlled, clinical trials. Recent advances in mechanical ventilation derived from successful application in adults include neurally adjusted ventilatory assist, noninvasive ventilation, and protective lung strategies. NAVA improves patient/ ventilator synchrony and reduces the work of breathing, which allows for a decreased use of sedation. This should decrease the length of time patients are intubated and mechanically ventilated. The use of noninvasive ventilation eliminates the need for endotracheal tubes and complications associated with them including tracheal injury, pressure ulcers, issues with oral hygiene and ventilator associated pneumonia. Application of lung protective strategies to pediatric patients with acute lung injury and/or ARDS results in increased oxygenation, less lung injury, and improvements in morbidity and mortality.

show abstract

Continuous negative extrathoracic pressure or continuous positive airway pressure compared to conventional ventilation for acute hypoxaemic respiratory failure in children

Shah¹,

Ohlsson²,

Shah³

2008

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

There is a lack of well designed, controlled experiments of non-invasive modes of respiratory support in children with AHRF. Reduction of in-hospital mortality is an important outcome and even a small reduction would be beneficial. Studies assessing other outcomes such as avoidance of intubation and its associated complications, reduction in hospital stay and improvement in patient comfort are also valuable in gauging the overall impact of these strategies.

show abstract

Noninvasive Continuous Positive Airway Pressure in Acute Respiratory Failure: Helmet Versus Facial Mask

Abstract: The results of this current study revealed that the helmet is a feasible alternative to the facial mask for delivery of nCPAP to infants with mild ARF.

Cited by 36 publications

References 26 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

Advances in Ventilatory Support of Critically Ill Children

Continuous negative extrathoracic pressure or continuous positive airway pressure compared to conventional ventilation for acute hypoxaemic respiratory failure in children

Contact Info

Product

Resources

About