Evaluation of a Low-Cost Bubble CPAP System Designed for Resource-Limited Settings
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Respiratory Care
Abstract
Respiratory compromise is a leading contributor to global neonatal death. CPAP
is a method of treatment that helps maintain lung volume during expiration, promotes comfortable
breathing, and improves oxygenation. Bubble CPAP is an effective alternative to standard
CPAP. We sought to determine the reliability and functionality of a low-cost bubble CPAP device
designed for low-resource settings. METHODS: The low-cost bubble CPAP device was compared
to a commercially available bubble CPAP system. The devices were connected to a lung simulator
that simulated neonates of 4 different weights with compromised respiratory mechanics ( 1, 3,
5, and 10 kg). The devices’ abilities to establish and maintain pressure and flow under normal
conditions as well as under conditions of leak were compared. Multiple combinations of pressure levels
(5, 8, and 10 cm H2O) and flow levels (3, 6, and 10 L/min) were tested. The endurance of both devices
was also tested by running the systems continuously for 8 h and measuring the changes in pressure and
flow. RESULTS: Both devices performed equivalently during the no-leak and leak trials. While our
testing revealed individual differences that were statistically significant and clinically important (>10%
difference) within specific CPAP and flow-level settings, no overall comparisons of CPAP or flow were
both statistically significant and clinically important. Each device delivered pressures similar to the
desired pressures, although the flows delivered by both machines were lower than the set flows in most
trials. During the endurance trials, the low-cost device was marginally better at maintaining pressure,
while the commercially available device was better at maintaining flow. CONCLUSIONS: The low-cost
bubble CPAP device evaluated in this study is comparable to a bubble CPAP system used in developed
settings. Extensive clinical trials, however, are necessary to confirm its effectiveness.
Description
Keywords
CPAP, BubbleCPAP, Respiratory distress, Low-resource settings, Uganda, Neonates
Citation
Bennett, D. J., Carroll, R. W., & Kacmarek, R. M. (2018). Evaluation of a low-cost bubble CPAP system designed for resource-limited settings. Respiratory Care, 63(4), 395-403. Doi: 10.4187/respcare.05762