Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Intensive Care Medicine
Published in: Intensive Care Medicine 6/2005

01-06-2005 | Pediatric Original

A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system

Authors: Daniele Trevisanuto, Nicoletta Grazzina, Nicoletta Doglioni, Paola Ferrarese, Francesco Marzari, Vincenzo Zanardo

Published in: Intensive Care Medicine | Issue 6/2005

Login to get access

Abstract

Objective

We compared the effectiveness of a new continuous positive airway pressure (CPAP) device (neonatal helmet CPAP) with a conventional nasal CPAP system in preterm neonates needing continuous distending pressure.

Design and setting

Randomized, physiological, cross-over study in a tertiary referral, neonatal intensive care unit in a university teaching hospital.

Patients

Twenty very low birth weight infants with a postnatal age greater than 24 h who were receiving nasal CPAP for apnea and/or mild respiratory distress were enrolled.

Interventions

CPAP delivered by neonatal helmet CPAP and nasal CPAP in random order for two subsequent 90-min periods.

Measurements and results

Were continuously measured the Neonatal Infant Pain Scale (NIPS) score, oxygen requirements, respiratory rate, heart rate, oxygen saturation, transcutaneous PO2 (tcPO2) and PCO2 (tcPCO2), blood pressure, and desaturations. NIPS scores were significantly lower when the infants were on the neonatal helmet CPAP than when they were on nasal CPAP (0.26±0.07 vs. 0.63±0.12). The other studied parameters did not differ between the two CPAP modes. The number of deaturations was reduced during the neonatal helmet CPAP treatment (18 vs. 32), although this difference was not significant.

Conclusions

In this short-term physiological study the neonatal helmet CPAP appears to be as good as the golden standard for managing preterm infants needing continuous distending pressure, with enhanced tolerability. Further evaluation in a randomized clinical trial is needed to confirm these findings.
Literature
1.
Avery ME, Tooley WH, Keller JB, Hurd SS, Bryan MH, Cotton RB (1987) Is chronic lung disease in low birth weight infants preventable? A survey of eight centres. Pediatrics 79:26–30
2.
Van Marter L, Allred EN, Pagano M, Sanocka U, Parad R, Moore M, Susser M, Paneth N, Leviton A (2000) Do clinical markers of barotraumas and oxygen toxicity explain interhospital variation in rates of chronic lung disease? Pediatrics 105:1194–1201
3.
Davis PG, Henderson-Smart DJ (2002) Nasal continuous positive airway pressure immediately after extubation for preventing morbidity in preterm infants. Cochrane Library, issue 1, Oxford
4.
Gregory GA, Kitterman JA, Phibbs RH, Tooley WA, Hamilton WK (1971) Treatment of the idiopathic respiratory distress system with continuous positive airway pressure. N Engl J Med 284:1333–1340
5.
Polin RA, Sahni R (2002) Newer experience with CPAP. Semin Neonatol 7:379–389
6.
De Paoli AG, Morley C, Davis PG (2003) Nasal CPAP for neonates: what do we know in 2003? Arch Dis Child Fetal Neonatal Ed 88:F168–F172
7.
Robertson NJ, McCarthy LS, Hamilton PA, Moss ALH (1996) Nasal deformities resulting from flow driver continuous positive airway pressure. Arch Dis Child 75:F209–F212
8.
Antonelli M, Conti G, Pelosi P, Gregoretti C, Pennisi MA, Costa R, Severgnini P, Chiaranda M, Proietti R (2002) New treatment of acute hypoxemic respiratory failure: noninvasive pressure support ventilation delivered by helmet-A pilot controlled trial. Crit Care Med 30:602–608
9.
Chiumello D, Pelosi P, Carlesso E, Severgnini P, Aspesi M, Gamberoni C, Antonelli M, Conti G, Chiaranda M, Gattinoni L (2003) Noninvasive positive pressure ventilation delivered by helmet vs. standard face mask. Intensive Care Med 29:1671–1679
10.
Patroniti N, Foti G, Manfio A, Coppo A, Bellani G, Pesenti A (2003) Head helmet versus face mask for non-invasive continuous positive airway pressure: a physiological study. Intensive Care Med 29:1680–1687
11.
Cavaliere F, Conti G, Costa R, Proietti R, Sciuto A, Masieri S (2004) Noise exposure during noninvasive ventilation with a helmet, a nasal mask, and a facial mask. Intensive Care Med 30:1755–1760
12.
Moa G, Nilsson K (1993) Nasal continuous positive airway pressure: experiences with a new technical approach. Acta Paediatr 82:210–211
13.
Lawrence J, Alcock D, McGrath P, Kay J, MacMurray S, Dulberg C (1993) The development of a tool to assess neonatal pain. Neonatal Netw 12:59–66
14.
Papile LA (1997) Intracranial hemorrhage. In: Fanaroff AA, Martin RJ (eds) Neonatal-perinatal medicine, chap 37. Mosby-Year Book, St. Louis, pp 891–899
15.
Vert P, Andre M, Sibiout M (1973) Continuous positive airway pressure and hydrocephalus. Lancet II:319
16.
Zaramella P, Trevisanuto D, Freato F, Quaresima V, Saraceni E, Chiandetti L (2004) Does Helmet-CPAP reduce cerebral blood flow by comparison with nasal CPAP in very low birth weight newborns? Pediatr Res 55:414A
17.
Courtney SE, Pyon KH, Saslow JG, Arnold GK, Pandit PB, Habib RH (2001) Lung recruitment and breathing pattern during variable versus continuous flow nasal continuous positive airway pressure in premature infants: an evaluation of three devices. Pediatrics 107:304–308
18.
Klausner JF, Lee AY, Hutchinson AA (1996) Decreased imposed work with a new nasal continuous positive airway pressure device. Pediatr Pulmonol 22:188–194
19.
De Paoli AG, Davis PG, Faber B (2002) Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in preterm neonates. Cochrane Library, issue 4, Oxford
20.
Stefanescu BM, Murphy WP, Hansell BJ, Fuloria M, Morgan TM, Aschner JL (2003) A randomized, controlled trial comparing two different continuous positive airway pressure systems for the successful extubation of extremely low birth weight infants. Pediatrics 112:1031–1038
21.
Goldman SL, Brady JP, Dumpit FM (1979) Increased work of breathing associated with nasal prongs. Pediatrics 64:160–164
22.
Hammer J (2001) Nasal CPAP in preterm infants—does it work and how? Intensive Care Med 27:1689–1691
Metadata
Title
A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system
Authors
Daniele Trevisanuto
Nicoletta Grazzina
Nicoletta Doglioni
Paola Ferrarese
Francesco Marzari
Vincenzo Zanardo
Publication date
01-06-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 6/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2638-9

Other articles of this Issue 6/2005

Intensive Care Medicine 6/2005 Go to the issue

Original

Apoptosis of Jurkat cells induced by serum of patients with acute severe brain injury

Pediatric Original

Severe traumatic brain injury in pediatric patients: treatment and outcome using an intracranial pressure targeted therapy—the Lund concept

Original

End-of-life decisions: a cohort study of the withdrawal of all active treatment in intensive care units in the United Kingdom

News

Glass v United Kingdom and Burke v General Medical Council. Judicial interpretations of European Convention Rights for patients in the United Kingdom facing decisions about life-sustaining treatment limitations

Original

Transcranial Doppler to detect on admission patients at risk for neurological deterioration following mild and moderate brain trauma

Pediatric Original

A prospective study of outcome predictors after severe brain injury in children