• Daniele Trevisanuto, Nicoletta Grazzina, Nicoletta Doglioni, Paola Ferrarese, Francesco Marzari, and Vincenzo Zanardo.
• Pediatric Department, Medical School, Padua University, Via Giustiniani 3, 35158 Padua, Italy. trevo@pediatria.unipd.it
• Intensive Care Med. 2005 Jun 1;31(6):859-64.

ObjectiveWe 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 SettingRandomized, physiological, cross-over study in a tertiary referral, neonatal intensive care unit in a university teaching hospital.PatientsTwenty 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.InterventionsCPAP delivered by neonatal helmet CPAP and nasal CPAP in random order for two subsequent 90-min periods.Measurements And ResultsWere continuously measured the Neonatal Infant Pain Scale (NIPS) score, oxygen requirements, respiratory rate, heart rate, oxygen saturation, transcutaneous PO(2) (tcPO(2)) and PCO(2) (tcPCO(2)), 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 desaturations was reduced during the neonatal helmet CPAP treatment (18 vs. 32), although this difference was not significant.ConclusionsIn 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.

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