Document Detail


Helmet continuous positive airway pressure vs oxygen therapy to improve oxygenation in community-acquired pneumonia: a randomized, controlled trial.
MedLine Citation:
PMID:  20154071     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our objective was to evaluate the efficacy of noninvasive continuous positive airway pressure (CPAP) delivered by helmet in improving oxygenation in comparison with oxygen therapy in community-acquired pneumonia (CAP). METHODS: This was a multicenter, randomized, controlled trial enrolling patients with CAP admitted to an ED with moderate hypoxemic acute respiratory failure (ARF) (Pa(O(2))/Fi(O(2)) ratio > or = 210 and < or = 285). Patients were randomized to helmet CPAP or standard oxygen therapy (control group). The primary end point was the time to reach a Pa(O(2))/Fi(O(2)) ratio > 315. After reaching this value, patients randomized to CPAP were switched to oxygen, and the proportion of subjects who could maintain a Pa(O(2))/Fi(O(2)) ratio > 315 at 1 h was recorded. RESULTS: Forty-seven patients were recruited: 20 randomized to CPAP and 27 to controls. Patients randomized to CPAP reached the end point in a median of 1.5 h, whereas controls reached the end point in 48 h (P < .001). The proportion of patients who reached the primary end point was 95% (19/20) among the CPAP group and 30% (8/27) among controls (P < .001). One hour after reaching the primary end point, 2/14 patients in the CPAP group maintained a Pa(O(2))/Fi(O(2)) value > 315. CONCLUSIONS: CPAP delivered by helmet rapidly improves oxygenation in patients with CAP suffering from a moderate hypoxemic ARF. This trial represents a proof-of-concept evaluation of the potential usefulness of CPAP in patients with CAP.
Authors:
Roberto Cosentini; Anna Maria Brambilla; Stefano Aliberti; Angelo Bignamini; Stefano Nava; Antonino Maffei; Renato Martinotti; Paolo Tarsia; Valter Monzani; Paolo Pelosi
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2010-02-12
Journal Detail:
Title:  Chest     Volume:  138     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  114-20     Citation Subset:  AIM; IM    
Affiliation:
Emergency Medicine Department, Gruppo NIV, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy. roberto.cosentini@policlinico.mi.it
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00603564
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MeSH Terms
Descriptor/Qualifier:
Aged
Community-Acquired Infections / metabolism,  therapy*
Equipment Design
Female
Follow-Up Studies
Head Protective Devices*
Humans
Male
Oxygen Consumption / physiology*
Oxygen Inhalation Therapy / methods*
Pneumonia, Bacterial / metabolism,  therapy*
Positive-Pressure Respiration / instrumentation*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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