Safety of aerosol therapy in children during noninvasive ventilation with helmet and total face mask

Garcia, L. Rodriguez; Medina, Alberto; Alapont, V. Modesto i; Loro, M.L. Palacios; Mayordomo-Colunga, Juan; Vivanco-Allende, Ana; Rey, Corsino

doi:10.1016/j.medin.2018.06.003

Cited by 2 publications

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References 12 publications

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“…Moreover, H-CPAP seems to reduce cerebral blood flow more than nasal masks [ 98 ]. Some authors have suggested that helmets allow effective delivery of nitric oxide [ 99 ] or aerosols [ 100 ].…”

Section: Use In the Paediatric Populationmentioning

confidence: 99%

The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

et al. 2021

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A helmet, comprising a transparent hood and a soft collar, surrounding the patient’s head can be used to deliver noninvasive ventilatory support, both as continuous positive airway pressure and noninvasive positive pressure ventilation (NPPV), the latter providing active support for inspiration. In this review, we summarize the technical aspects relevant to this device, particularly how to prevent CO2 rebreathing and improve patient–ventilator synchrony during NPPV. Clinical studies describe the application of helmets in cardiogenic pulmonary oedema, pneumonia, COVID-19, postextubation and immune suppression. A section is dedicated to paediatric use. In summary, helmet therapy can be used safely and effectively to provide NIV during hypoxemic respiratory failure, improving oxygenation and possibly leading to better patient-centred outcomes than other interfaces.

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Section: Use In the Paediatric Populationmentioning

confidence: 99%

The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

et al. 2021

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“…After titles and abstracts screening, 30 citations with full-text were retrieved for detailed evaluation. After reviewing, 18 studies were excluded for the following reasons: non-RCT (n = 6) [18][19][20][21][22][23], review article (n = 5) [24][25][26][27][28], subjects were infants (n = 3) [29][30][31], subjects were healthy volunteers (n = 2) [32,33], animal trial (n = 1) [34] and news (n = 1) [35]. Finally, seven English studies [9][10][11][12][36][37][38] and five Chinese studies [39][40][41][42][43] matched the inclusion criteria and were suitable for our meta-analysis.…”

Section: Study Selectionmentioning

confidence: 99%

The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis

et al. 2021

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Objective To compare the safety and effectiveness between helmet and face mask noninvasive mechanical ventilation (NIMV) in patients with acute respiratory failure (ARF). Methods English databases included PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Chinese databases involved Wanfang Data, China Knowledge Resource Integrated Database and Chinese Biological Medicine Database. Randomized controlled trials (RCTs) comparing helmet and face mask NIMV for patients with ARF were searched. Meta-analysis was performed using Review manager 5.1.0. Results Twelve trials with a total of 569 patients were eligible. Our meta-analysis showed that, comparing with face mask, helmet could significantly decrease the incidences of intolerance [risk ratio (RR) 0.19; 95% confidence interval (CI) 0.09−0.39], facial skin ulcer (RR 0.19; 95% CI 0.08−0.43) and aerophagia (RR 0.15; 95% CI 0.06−0.37), reduce respiratory rate [mean difference (MD) -3.10; 95% CI -4.85 to -1.34], intubation rate (RR 0.39; 95% CI 0.26−0.59) and hospital mortality (RR 0.62; 95% CI 0.39−0.99) in patients with ARF, and improve oxygenation index in patients with hypoxemic ARF (MD 55.23; 95% CI 31.37−79.09). However, subgroupanalysis for hypercapnic ARF revealed that PaCO2 was significantly reduced in face mask group compared with helmet group (MD 5.34; 95% CI 3.41−7.27). Conclusion NIMV with helmet can improve the patient’s tolerance, reduce adverse events, increase oxygenation effect, and decrease intubation rate and hospital mortality comparing to face mask. However, the low number of patients from included studies may preclude strong conclusions. Large RCTs are still needed to provide more robust evidence.

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Safety of aerosol therapy in children during noninvasive ventilation with helmet and total face mask

Abstract: The probability of suffering an adverse effect related to nebulization is extremely low when using a helmet or TFM. Inhaled therapy with TFM may shorten PICU stay in some patients.

Cited by 2 publications

References 12 publications

The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

The use of head helmets to deliver noninvasive ventilatory support: a comprehensive review of technical aspects and clinical findings

The roles of noninvasive mechanical ventilation with helmet in patients with acute respiratory failure: A systematic review and meta-analysis

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