RT Journal Article
SR Electronic
T1 Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress
JF Respiratory Care
FD American Association for Respiratory Care
SP 1036
OP 1042
DO 10.4187/respcare.05384
VO 62
IS 8
A1 Vitaliti, Giovanna
A1 Vitaliti, Maria Concetta
A1 Finocchiaro, Maria Carla
A1 Di Stefano, Vita Antonella
A1 Pavone, Piero
A1 Matin, Nassim
A1 Motamed-Gorji, Nazgol
A1 Lubrano, Riccardo
A1 Falsaperla, Raffaele
YR 2017
UL http://rc.rcjournal.com/content/62/8/1036.abstract
AB 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.