{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T20:44:17Z","timestamp":1775508257625,"version":"3.50.1"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In this multicenter randomized controlled trial, 30 infants with respiratory syncytial virus-induced ARF were randomized to receive CPAP by helmet (n = 17) or facial mask (n = 13). The primary endpoint was treatment failure rate (defined as due to intolerance or need for intubation). Secondary outcomes were CPAP application time, number of patients requiring sedation, and complications with each interface.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Compared with the facial mask, CPAP by helmet had a lower treatment failure rate due to intolerance (3\/17 [17%] vs 7\/13 [54%], P = .009), and fewer infants required sedation (6\/17 [35%] vs 13\/13 [100%], P = .023); the intubation rates were similar. In successfully treated patients, CPAP resulted in better gas exchange and breathing pattern with both interfaces. No major complications due to the interfaces occurred, but CPAP by mask had higher rates of cutaneous sores and leaks.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>These findings confirm that CPAP delivered by helmet is better tolerated than CPAP delivered by facial mask and requires less sedation. In addition, it is safe to use and free from adverse events, even in a prolonged clinical setting.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2014-1142","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:48:40Z","timestamp":1426553320000},"page":"e868-e875","source":"Crossref","is-referenced-by-count":38,"title":["Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT"],"prefix":"10.1542","volume":"135","author":[{"given":"Giovanna","family":"Chidini","sequence":"first","affiliation":[{"name":"Pediatric ICU, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico, Milan, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Piastra","sequence":"additional","affiliation":[{"name":"Pediatric ICU, Department of Anaesthesiology and Intensive Care, University Hospital \u201cA. Gemelli,\u201d Catholic University of the Sacred Heart, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Marchesi","sequence":"additional","affiliation":[{"name":"University of Milan, Milan, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"De Luca","sequence":"additional","affiliation":[{"name":"Pediatric ICU, Department of Anaesthesiology and Intensive Care, University Hospital \u201cA. Gemelli,\u201d Catholic University of the Sacred Heart, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Pediatric ICU, Department of Anesthesia and Critical Care, Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico, Milan, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida","family":"Salvo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Children\u2019s Hospital Vittore Buzzi, Istituti Clinici di Perfezionamento, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Wolfler","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Children\u2019s Hospital Vittore Buzzi, Istituti Clinici di Perfezionamento, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Pelosi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, IRCCS AOU San Martino \u2013 IST, Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirco","family":"Damasco","sequence":"additional","affiliation":[{"name":"University of Milan, Milan, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Conti","sequence":"additional","affiliation":[{"name":"Pediatric ICU, Department of Anaesthesiology and Intensive Care, University Hospital \u201cA. 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