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Pediatr Crit Care Me · Sep 2006
Continuous positive airway pressure with modified helmet for treatment of hypoxemic acute respiratory failure in infants and a preschool population: a feasibility study.
- Daniela Codazzi, Mirco Nacoti, Maurizio Passoni, Ezio Bonanomi, Lidia Rota Sperti, and Roberto Fumagalli.
- Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Ospedali Riuniti, Bergamo, Italy.
- Pediatr Crit Care Me. 2006 Sep 1;7(5):455-60.
ObjectiveTo analyze the feasibility of using continuous positive airway pressure (CPAP) delivered via a modified helmet to treat children with hypoxemic acute respiratory failure.DesignA single-center, prospective, clinical study.SettingPediatric intensive care unit in a university hospital.PatientsFifteen consecutive children (from 1 month to 5 yrs of age) with hypoxemic acute respiratory failure (defined as Pao2/Fio2 <300).InterventionsCPAP 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.Measurements And Main ResultsTen 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.ConclusionsThe 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.
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