Musolino Anna Maria, Persia Sabrina, Supino Maria Chiara, Stoppa Francesca, Rotondi Aufiero Lelia, Nacca Raffaella, Papini Laura, Pisani Mara, Cristaldi Sebastian, Vittucci Anna Chiara, Antilici Livia, Cecchetti Corrado, Raponi Massimiliano, Nadkarni Vinay, Villani Alberto
Emergency, Acceptance and General Pediatrics Department, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy.
Children (Basel). 2024 Oct 22;11(11):1273. doi: 10.3390/children11111273.
(1) Background: Helmet Continuous Positive Airway Pressure (H-CPAP) has primarily been used in intensive care settings to treat moderate-to-severe bronchiolitis in infants. We aim to report on the feasibility of H-CPAP for selected infants with bronchiolitis in a pediatric ward. (2) Methods: A retrospective, observational, consecutive case series was studied of 26 patients who received H-CPAP on the pediatric ward from October 2022 to February 2023, including a description of patient outcomes and costs. (3) Results: Of 130 infants with bronchiolitis admitted to Bambino Gesù Hospital in Rome, 34 were hospitalized for moderate to severe bronchiolitis, and 26 began H-CPAP on the ward. Among the 26 pediatric patients who received H-CPAP on the ward, 4 out of 26 (15%) required transfer to the PICU within the first hours of care due to clinical deterioration. No problems with the H-CPAP interface or side effects attributable to H-CPAP were reported. Pharmacological sedation with a single dose of dexmedetomidine was required for 15/26 patients (57%) following failure of non-pharmacological anxiety reduction strategies. After introducing H-CPAP in our pediatric ward, we achieved total cost savings of approximately EUR 147,120. (4) Conclusions: Treatment with H-CPAP for infants with bronchiolitis may be feasible in non-intensive care settings with trained staff, appropriate monitoring, and rapid access to pediatric intensive care.
（1）背景：头盔式持续气道正压通气（H-CPAP）主要用于重症监护环境中治疗婴儿中重度细支气管炎。我们旨在报告在儿科病房中对选定的细支气管炎婴儿使用H-CPAP的可行性。（2）方法：对2022年10月至2023年2月在儿科病房接受H-CPAP治疗的26例患者进行了一项回顾性、观察性、连续病例系列研究，包括对患者结局和成本的描述。（3）结果：在罗马的 Bambino Gesù 医院收治的130例细支气管炎婴儿中，34例因中重度细支气管炎住院，26例在病房开始使用H-CPAP。在病房接受H-CPAP治疗的26例儿科患者中，26例中有4例（15%）在护理的最初几小时内由于临床病情恶化需要转至儿科重症监护病房（PICU）。未报告H-CPAP接口问题或归因于H-CPAP的副作用。在非药物性减轻焦虑策略失败后，15/26例患者（57%）需要单次剂量右美托咪定进行药物镇静。在我们的儿科病房引入H-CPAP后，我们总共节省了约147,120欧元的成本。（4）结论：在有经过培训的工作人员、适当监测且能快速转入儿科重症监护的非重症监护环境中，用H-CPAP治疗细支气管炎婴儿可能是可行的。
