Respiratory failure due to upper airway obstruction in children: use of the helmet as bridge interface.

Abstract:

:Upper airway obstruction (UAO) can cause severe respiratory distress in young children by increasing inspiratory muscle load and decreasing alveolar ventilation, ultimately resulting in hypercapnia and hypoxemia which have long term negative cardiovascular effects. Although non-invasive continuous positive airway pressure (CPAP) improves gas exchange in these patients, use of conventional interfaces (nasal mask, nasal pillow and facial mask) may cause significant discomfort and lead to CPAP intolerance. We report five cases of children affected by UAO who experienced CPAP intolerance via application of conventional interfaces. Alternatively, we acutely applied helmet-CPAP which resulted in improved breathing pattern and gas exchange. Thereafter, patients received training with respect to a nasal CPAP interface, allowing successful long term treatment. In conclusion, these five clinical cases demonstrate that helmet-CPAP can be used acutely in children with UAO if compliance to conventional modalities is problematic, allowing for sufficient time to achieve compliance to nasal-CPAP.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

Racca F,Cutrera R,Robba C,Caldarelli V,Paglietti MG,De Angelis MC,Sekhon MS,Gualino J,Bella C,Passoni N,Ranieri VM

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

175-8

issue

2

eissn

0375-9393

issn

1827-1596

pii

R02Y9999N00A140894

journal_volume

81

pub_type

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