title: Noise exposure is increased with neonatal helmet CPAP in comparison with conventional nasal CPAP.
abstract: BACKGROUND
  in adults, noninvasive ventilation via a helmet is associated with significantly greater noise than nasal and facial masks. We hypothesized that noise exposure could be increased with neonatal helmet continuous positive airway pressure (CPAP) in comparison with conventional nasal CPAP (nCPAP). Our primary objective was to compare the noise intensity produced by a neonatal helmet CPAP and a conventional nCPAP system. Furthermore, we aimed to evaluate the effect of the gas flow rate and the presence of the humidifier and the filter on noise levels during neonatal helmet CPAP treatment.
  
  
  METHODS
  in this bench study, noise intensity was measured in the following settings: helmet CPAP, nCPAP, incubator and the neonatal intensive care unit. In helmet CPAP, noise measurements were performed at different gas flow rates (8, 10 and 12 l/min), while in nCPAP, the flow rate was 8 l/min. For both CPAP systems, the level of pressure was maintained constant at 5 cmH(2) O.
  
  
  RESULTS
  during neonatal helmet CPAP, the median (interquartile range) noise levels were significantly higher than those during nCPAP: 70.0 dB (69.9-70.4) vs. 62.7 dB (62.5-63.0); P<0.001. In the helmet CPAP, the noise intensities changed with increasing flow rate and with the presence of a humidifier or a filter.
  
  
  CONCLUSIONS
  noise intensities generated by the neonatal helmet CPAP were significantly higher than those registered while using a conventional nCPAP system. In the helmet, the noise intensity depends on the gas flow rate, and the presence of a humidifier and a filter in the system.
authors.affiliation: Departments of Pediatric, Medical School, University of Padua, Azienda Ospedaliera di Padova, Padua, Italy. trevo@pediatria.unipd.it
authors.forename: D
authors.initials: D
authors.lastname: Trevisanuto
authors.forename: L
authors.initials: L
authors.lastname: Camiletti
authors.forename: N
authors.initials: N
authors.lastname: Doglioni
authors.forename: F
authors.initials: F
authors.lastname: Cavallin
authors.forename: A
authors.initials: A
authors.lastname: Udilano
authors.forename: V
authors.initials: V
authors.lastname: Zanardo
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D005374:Filtration; D006260:Head Protective Devices; D006801:Humans; D006813:Humidity; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009622:Noise / Q000009:adverse effects*