Continuous positive airway pressure with modified helmet for treatment of hypoxemic acute respiratory failure in infants and a preschool population: a feasibility study.
OBJECTIVE
To analyze the feasibility of using continuous positive airway pressure (CPAP) delivered via a modified helmet to treat children with hypoxemic acute respiratory failure.


METHODS
A single-center, prospective, clinical study.


METHODS
Pediatric intensive care unit in a university hospital.


METHODS
Fifteen consecutive children (from 1 month to 5 yrs of age) with hypoxemic acute respiratory failure (defined as Pao2/Fio2 <300).


METHODS
CPAP was delivered via a modified helmet (CaStar, Starmed, Italy) of reduced size, fastened by a device we call a "baby-body." The feasibility of CPAP with the helmet was the primary end point. The improvement of gas exchange was the secondary one.


RESULTS
Ten of 15 children had multiple organ failure. Nine of 15 children were </=1 yr old. The helmet was well tolerated by all the children. Additional sedation was provided to four patients. No children developed significant complications (skin lesion, gastric distension, conjunctivitis, epistaxis, or loss of invasive devices) or lethal, helmet-related events. Oxygenation improved above baseline after 2 hrs of CPAP with the helmet; no significant variation of hemodynamic variables was detected.


CONCLUSIONS
The helmet is a suitable device for delivery of CPAP to infants and preschool children with hypoxemic acute respiratory failure. It was well tolerated and improved oxygenation.
Codazzi
Daniela
D
Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Ospedali Riuniti, Bergamo, Italy.
Nacoti
Mirco
M
Passoni
Maurizio
M
Bonanomi
Ezio
E
Sperti
Lidia Rota
LR
Fumagalli
Roberto
R
D000208:Acute Disease; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D005240:Feasibility Studies; D006260:Head Protective Devices; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012131:Respiratory Insufficiency / Q000628:therapy*