Document Detail


Treatment of acute hypoxemic respiratory failure with continuous positive airway pressure delivered by a new pediatric helmet in comparison with a standard full face mask: a prospective pilot study.
MedLine Citation:
PMID:  19794328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the feasibility and efficacy of continuous positive airway pressure delivered by a new pediatric helmet in comparison with a standard facial mask in infants with acute hypoxemic respiratory failure.
DESIGN: A single-center prospective case-control study.
SETTING: Pediatric intensive care unit in a tertiary children hospital.
PATIENTS AND INTERVENTIONS: Twenty consecutive infants treated with continuous positive airway pressure by a helmet matched with a control patient treated with continuous positive airway pressure by facial mask and selected by age, weight, PaO2:Fio2, and PaCO2 on pediatric intensive care unit admission.
MEASUREMENTS AND MAIN RESULTS: Feasibility was defined as the incidence of continuous positive airway pressure protocol failure secondary to 1) failure to administer continuous positive airway pressure because of intolerance to the interface; 2) deterioration in gas exchange soon after continuous positive airway pressure institution; and 3) major clinical adverse events such as pneumothorax or any hemodynamic instability related to the continuous positive airway pressure safety system device's failure. Evaluation of feasibility included also the total application time of respiratory treatment, the number of continuous positive airway pressure discontinuations/first 24 hrs. Interface-related complications included air leaks, cutaneous pressure sores, eye irritation, inhalation, and gastric distension. The 20 patients and control subjects had similar matching characteristics. Continuous positive airway pressure delivered by a helmet compared with a facial mask reduced continuous positive airway pressure trial failure rate (p = .02), increased application time (p = .001) with less discontinuations (p = .001), and was not associated with an increased rate of major adverse events, resulting in decreased air leaks (p = .04) and pressure sores (p = .002). Both continuous positive airway pressure systems resulted in early and sustained improvement in oxygenation.
CONCLUSIONS: The helmet might be considered a viable and safe alternative to a standard facial mask to deliver continuous positive airway pressure in hypoxemic infants in the pediatric intensive care unit setting. In our study, the helmet allowed more prolonged application of continuous positive airway pressure compared with a facial mask, ensuring similar improvement in oxygenation without any adverse events and clinical intolerance.
Authors:
Giovanna Chidini; Edoardo Calderini; Paolo Pelosi
Related Documents :
16838048 - Continuous positive airway pressure ameliorated severe pulmonary hypertension associate...
17931878 - High flow nasal oxygen generates positive airway pressure in adult volunteers.
12869358 - Static and dynamic upper airway obstruction in sleep apnea: role of the breathing gas p...
17823298 - Mechanisms of breathing instability in patients with obstructive sleep apnea.
17545938 - Relationship between physiologic deadspace/tidal volume ratio and gas exchange in infan...
879018 - Altered hemoglobin-oxygen affinity with long-term propranolol therapy in patients with ...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  11     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  502-8     Citation Subset:  IM    
Affiliation:
Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, IRCCS Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. giovannachid@libero.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anoxia / therapy*
Continuous Positive Airway Pressure / instrumentation*
Equipment Design
Feasibility Studies
Female
Humans
Infant
Intensive Care Units, Pediatric
Male
Masks*
Outcome Assessment (Health Care)
Pilot Projects
Prospective Studies
Respiratory Insufficiency / therapy*

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


Previous Document:  Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonar...
Next Document:  Impact of hypothermia in the rural, pediatric trauma patient*