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J Pediatr Intensive Care
DOI: 10.1055/s-0042-1760634
Original Article

Acceptance and Tolerability of Helmet CPAP in Pediatric Bronchiolitis and Pneumonia: A Feasibility Study

Michele E. Smith 
1   Division of Pediatric Critical Care, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center Golisano Children's Hospital, Rochester, New York, United States
,
Meghan Gray
2   Division of Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York Presbyterian Morgan Stanley Children's Hospital, New York, New York, United States
,
Patrick T. Wilson
3   Division of Pediatric Critical Care, Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital of Colorado, Aurora, Colorado, United States
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Abstract

Continuous positive airway pressure (CPAP) is a form of non-invasive ventilation used to support pediatric patients with acute respiratory infections. Traditional CPAP interfaces have been associated with inadequate seal, mucocutaneous injury, and aerosolization of infectious particles. The helmet interface may be advantageous given its ability to create a complete seal, avoid skin breakdown, and decrease aerosolization of viruses. We aim to measure tolerability and safety in a pediatric population in the United States and ascertain feedback from parents and health care providers. We performed a prospective, open-label, single-armed feasibility study to assess tolerability and safety of helmet CPAP. Pediatric patients 1 month to 5 years of age admitted to the pediatric intensive care unit with pulmonary infections who were on CPAP for at least 2 hours were eligible. The primary outcome was percentage of patients tolerating helmet CPAP for 4 hours. Secondary measures included the rate of adverse events and change in vital signs. Qualitative feedback was obtained from families, nurses, and respiratory therapists. Five patients were enrolled and 100% tolerated helmet CPAP the full 4-hour study period. No adverse events or significant vital sign changes were observed. All family members preferred to continue the helmet interface, nursing staff noted it made cares easier, and respiratory therapists felt the set up was easy. Helmet CPAP in pediatric patients is well-tolerated, safe, and accepted by medical staff and families in the United States future randomized controlled trials measuring its effectiveness compared with traditional CPAP interfaces are needed.

Keywords

CPAP - helmet - bronchiolitis - pneumonia - PICU

Clinical Trial Registry

ClinicalTrials.gov (NCT04764929); https://clinicaltrials.gov/ct2/show/NCT04764929.




Publication History

Received: 22 September 2022

Accepted: 14 December 2022

Article published online:
13 January 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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