Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome
Background. In pediatric patients with severe COVID-19, if the respiratory support provided using high-flow nasal cannula (HFNC) becomes insufficient, no definitive evidence exists to support the escalation to noninvasive ventilation (NIV) or mechanical ventilation (MV). Case Presentation. A 9-year-...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2024/5519254 |
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| author | Ke-Yun Chao Chao-Yu Chen Xiao-Ru Ji Shu-Chi Mu Yu-Hsuan Chien |
| author_facet | Ke-Yun Chao Chao-Yu Chen Xiao-Ru Ji Shu-Chi Mu Yu-Hsuan Chien |
| author_sort | Ke-Yun Chao |
| collection | DOAJ |
| description | Background. In pediatric patients with severe COVID-19, if the respiratory support provided using high-flow nasal cannula (HFNC) becomes insufficient, no definitive evidence exists to support the escalation to noninvasive ventilation (NIV) or mechanical ventilation (MV). Case Presentation. A 9-year-old boy being treated with face mask-delivered biphasic positive airway pressure ventilation developed fever, tachypnea, and frequent desaturation. The COVID-19 polymerase chain reaction test and urine antigen test for Streptococcus pneumoniae were both positive, and sputum culture yielded Pseudomonas aeruginosa. The do-not-resuscitate order precluded the use of endotracheal intubation. After 2 h of HFNC support, the respiratory rate oxygenation (ROX) index declined from 7.86 to 3.71, indicating impending HFNC failure. A helmet was used to deliver NIV, and SpO2 was maintained at >90%. Dyspnea and desaturation gradually improved, and the patient was switched to HFNC 6 days later and discharged 10 days later. Conclusion. In some cases, acute respiratory distress syndrome severity cannot be measured using the oxygenation index or oxygenation saturation index, and the SpO2/FiO2 ratio and ROX index may serve as useful alternatives. Although NIV delivered through a facemask or HFNC is more popular than helmet-delivered NIV, in certain circumstances, it can help escalate respiratory support while providing adequate protection to healthcare professionals. |
| format | Article |
| id | doaj-art-4ea0f23eab6546b88b8a0688e3a961f9 |
| institution | Kabale University |
| issn | 2090-6811 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-4ea0f23eab6546b88b8a0688e3a961f92025-02-02T23:15:16ZengWileyCase Reports in Pediatrics2090-68112024-01-01202410.1155/2024/5519254Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress SyndromeKe-Yun Chao0Chao-Yu Chen1Xiao-Ru Ji2Shu-Chi Mu3Yu-Hsuan Chien4Department of Respiratory TherapyDepartment of Respiratory TherapyDepartment of PediatricsDepartment of PediatricsDepartment of PediatricsBackground. In pediatric patients with severe COVID-19, if the respiratory support provided using high-flow nasal cannula (HFNC) becomes insufficient, no definitive evidence exists to support the escalation to noninvasive ventilation (NIV) or mechanical ventilation (MV). Case Presentation. A 9-year-old boy being treated with face mask-delivered biphasic positive airway pressure ventilation developed fever, tachypnea, and frequent desaturation. The COVID-19 polymerase chain reaction test and urine antigen test for Streptococcus pneumoniae were both positive, and sputum culture yielded Pseudomonas aeruginosa. The do-not-resuscitate order precluded the use of endotracheal intubation. After 2 h of HFNC support, the respiratory rate oxygenation (ROX) index declined from 7.86 to 3.71, indicating impending HFNC failure. A helmet was used to deliver NIV, and SpO2 was maintained at >90%. Dyspnea and desaturation gradually improved, and the patient was switched to HFNC 6 days later and discharged 10 days later. Conclusion. In some cases, acute respiratory distress syndrome severity cannot be measured using the oxygenation index or oxygenation saturation index, and the SpO2/FiO2 ratio and ROX index may serve as useful alternatives. Although NIV delivered through a facemask or HFNC is more popular than helmet-delivered NIV, in certain circumstances, it can help escalate respiratory support while providing adequate protection to healthcare professionals.http://dx.doi.org/10.1155/2024/5519254 |
| spellingShingle | Ke-Yun Chao Chao-Yu Chen Xiao-Ru Ji Shu-Chi Mu Yu-Hsuan Chien Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome Case Reports in Pediatrics |
| title | Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome |
| title_full | Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome |
| title_fullStr | Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome |
| title_full_unstemmed | Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome |
| title_short | Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome |
| title_sort | helmet ventilation in a child with covid 19 and acute respiratory distress syndrome |
| url | http://dx.doi.org/10.1155/2024/5519254 |
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