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Continuous positive airway pressure ventilation with helmet in infants under 1 year

Christophe Milési1, Félicie Ferragu, Samir Jaber

  • 1Pediatric Intensive Care Unit, CHU Montpellier, 34000, Montpellier, France.

Intensive Care Medicine
|July 8, 2010
PubMed

Insights

Helmet CPAP is a feasible treatment for infants with acute respiratory failure, showing success in over two-thirds of cases. While generally well-tolerated, caregivers should monitor for pressure sores and be aware of high humidity and noise levels.

Area of Science:

  • Pediatric critical care
  • Respiratory medicine
  • Medical device engineering

Background:

  • Acute respiratory failure is a critical condition in infants.
  • Continuous Positive Airway Pressure (CPAP) is a common treatment.
  • Helmet interfaces offer an alternative to nasal CPAP for infants.

Purpose of the Study:

  • To evaluate the feasibility of using helmet CPAP in infants aged 1-12 months with acute respiratory failure.
  • To assess the efficacy and tolerance of helmet CPAP in this population.

Main Methods:

  • A prospective observational study involving 23 infants (median age 5 months) with acute respiratory failure.
  • Helmet CPAP at 6 cm H2O was applied, with observations before and 2 hours after.
  • Failure was defined as the need for mechanical ventilation; stabilization or improvement was based on respiratory parameters. Tolerance was assessed via pain scores, skin checks, humidity, and noise levels.

Main Results:

  • Helmet CPAP failed in 9% of infants, while 70% showed stability or improvement.
  • 96% of infants experienced stable or improved pain and discomfort scores.
  • Pressure sores occurred in 13% of infants. High humidity (98%) and noise levels (81 dB-SPL) were recorded.

Conclusions:

  • Helmet CPAP is a satisfactory interface for delivering CPAP to young infants in over two-thirds of cases.
  • Preventing pressure sores is possible with cushioning.
  • Caregivers must manage the high humidity and noise associated with the helmet interface.
Abstract

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