• Respiratory care · Aug 2017

    Randomized Controlled Trial Observational Study

    Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress.

    • Giovanna Vitaliti, Maria Concetta Vitaliti, Maria Carla Finocchiaro, Vita Antonella Di Stefano, Piero Pavone, Nassim Matin, Nazgol Motamed-Gorji, Riccardo Lubrano, and Raffaele Falsaperla.
    • Pediatric General and Acute and Emergency Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy. giovitaliti@yahoo.it.
    • Respir Care. 2017 Aug 1; 62 (8): 1036-1042.

    BackgroundThe current study aimed to compare the efficacy and safety of 2 noninvasive respiratory support methods, which included helmet CPAP and high-flow nasal cannula (HFNC) in children with respiratory distress admitted to a pediatric intermediate care unit.MethodsThis study was a prospective observational study conducted on children with respiratory distress (age 1-24 months) who were admitted to our acute and emergency operative unit. All included subjects were randomly treated with helmet CPAP or HFNC in a 1:1 fashion until their clinical picture, oxygen saturation, and arterial blood gas (ABG) parameters resolved. The efficiencies of helmet CPAP and HFNC were evaluated by breathing frequency, SpO2 , ABG pH, ABG PaCO2 , ABG PaO2 , and PaO2 /FIO2 , recorded once at baseline and then after 1 and 6 h of treatment. Both noninvasive respiratory support modalities were compared with a control group of subjects with respiratory distress under standard therapeutic pharmaceutical protocols.ResultsWe found that both helmet CPAP and HFNC were efficient in improving the clinical conditions of subjects with mild-to-moderate respiratory distress, although clinical response to helmet CPAP was more efficient and rapid compared with HFNC. Children who received respiratory support had a better clinical course in terms of hospitalization, days of intravenous rehydration therapy, and days of drug administration compared with the control group (P < .001).ConclusionsBased on our knowledge, the present study is the first research comparing the effects of CPAP and HFNC in respiratory distress resolution in a pediatric intermediate care setting. It aims to identify the most efficient treatment to avoid pediatric ICU admissions and endotracheal intubation and reduce the administration of drugs and days of hospitalization.Copyright © 2017 by Daedalus Enterprises.

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