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Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress.
Respir Care. 2017 Aug; 62(8):1036-1042.RC

Abstract

BACKGROUND

The 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.

METHODS

This 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.

RESULTS

We 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).

CONCLUSIONS

Based 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.

Authors+Show Affiliations

Pediatric General and Acute and Emergency Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy. giovitaliti@yahoo.it.Pediatric General and Acute and Emergency Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy.Pediatric General and Acute and Emergency Operative Unit, Cannizzaro Hospital, Catania, Italy.Pediatric General and Acute and Emergency Operative Unit, Cannizzaro Hospital, Catania, Italy.Pediatric General and Acute and Emergency Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy.School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.Pediatric Nephrology Operative Unit, La Sapienza University of Rome, Italy.Pediatric General and Acute and Emergency Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy.

Pub Type(s)

Journal Article
Observational Study
Randomized Controlled Trial

Language

eng

PubMed ID

28487415

Citation

Vitaliti, Giovanna, et al. "Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress." Respiratory Care, vol. 62, no. 8, 2017, pp. 1036-1042.
Vitaliti G, Vitaliti MC, Finocchiaro MC, et al. Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress. Respir Care. 2017;62(8):1036-1042.
Vitaliti, G., Vitaliti, M. C., Finocchiaro, M. C., Di Stefano, V. A., Pavone, P., Matin, N., Motamed-Gorji, N., Lubrano, R., & Falsaperla, R. (2017). Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress. Respiratory Care, 62(8), 1036-1042. https://doi.org/10.4187/respcare.05384
Vitaliti G, et al. Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress. Respir Care. 2017;62(8):1036-1042. PubMed PMID: 28487415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress. AU - Vitaliti,Giovanna, AU - Vitaliti,Maria Concetta, AU - Finocchiaro,Maria Carla, AU - Di Stefano,Vita Antonella, AU - Pavone,Piero, AU - Matin,Nassim, AU - Motamed-Gorji,Nazgol, AU - Lubrano,Riccardo, AU - Falsaperla,Raffaele, Y1 - 2017/05/09/ PY - 2017/5/11/pubmed PY - 2018/4/25/medline PY - 2017/5/11/entrez KW - CPAP KW - HFNC KW - acute respiratory failure KW - efficiency KW - noninvasive respiratory support KW - pediatric intermediate care SP - 1036 EP - 1042 JF - Respiratory care JO - Respir Care VL - 62 IS - 8 N2 - BACKGROUND: The 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. METHODS: This 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. RESULTS: We 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). CONCLUSIONS: Based 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. SN - 1943-3654 UR - https://www.unboundmedicine.com/medline/citation/28487415/Randomized_Comparison_of_Helmet_CPAP_Versus_High_Flow_Nasal_Cannula_Oxygen_in_Pediatric_Respiratory_Distress_ L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&amp;pmid=28487415 DB - PRIME DP - Unbound Medicine ER -