Use of a modified bubble continuous positive airway pressure (bCPAP) device for children in respiratory distress in low- and middle-income countries: a safety study

Simple item page
dc.contributor.authorBjorklund, Ashley R.
dc.contributor.authorOdongkara Mpora, Beatrice
dc.contributor.authorSteiner, Marie E.
dc.contributor.authorFischer, Gwenyth
dc.contributor.authorDavey, Cynthia S.
dc.contributor.authorSlusher, Tina M.
dc.date.accessioned2023-02-12T21:04:42Z
dc.date.available2023-02-12T21:04:42Z
dc.date.issued2019
dc.description.abstractWhile bubble continuous positive airway pressure (bCPAP) is commonly used in low- and middle-income countries (LMIC) to support neonates with respiratory distress, there are limited non-invasive support options for non-neonatal children. Aim: To demonstrate safety of a new device designed to support children during respiratory distress in LMIC. Methods: A paediatric bCPAP device was designed called SEAL-bCPAP (Simplified Ear-plug Adapted-bCPAP). SEAL-bCPAP is constructed from inexpensive, easily obtainable materials. The nasal prong interface was modified from previously described neonatal bCPAP set-ups using commercial ear-plug material to improve nasal seal. A prospective interventional study was conducted to evaluate safety in children with respiratory distress treated with SEAL-bCPAP. Patients aged 30 days to 5 years presenting to a hospital in northern Uganda from July 2015 to June 2016 were screened. Those with moderate–severe respiratory distress and/or hypoxia despite nasal cannula oxygen were eligible for study. Enrolled patients were supported with SEAL-bCPAP until respiratory improvement or death. Complications attributable to SEAL-bCPAP were recorded. Clinical outcomes were compared with historical control pre-trial data. Results: Eighty-three of 87 enrolled patients were included in the final analysis. No patients had significant SEAL-bCPAP complications. Five patients had mild complications which resolved (four with nasal irritation and one with abdominal distention). Trial patients had significant (P < 0.0001) improvement in their TAL score, respiratory rate and O2sat after 2 h of SEAL-bCPAP. Fifty-two of 64 patients (62.7%) with severe illness at Time1 did not have severe illness at Time2 (after 2 h of SEAL-bCPAP) (p < 0.0001). Unadjusted mortality rates were 12.2% (6/49) and 9.6% (8/83), respectively, for pre-trial (historical control) and trial patients (p = 0.64); the study was not powered to show efficacy. Conclusions: The SEAL-bCPAP device is safe for treatment of respiratory distress in non-neonatal children in LMIC. There is a trend toward decreased mortality that should be evaluated with adequately powered clinical trials.en_US
dc.identifier.citationAshley R. Bjorklund, Beatrice Odongkara Mpora, Marie E. Steiner, Gwenyth Fischer, Cynthia S. Davey & Tina M. Slusher (2019) Use of a modified bubble continuous positive airway pressure (bCPAP) device for children in respiratory distress in low- and middleincome countries: a safety study, Paediatrics and International Child Health, 39:3, 160-167, DOI: 10.1080/20469047.2018.1474698en_US
dc.identifier.other10.1080/20469047.2018.1474698
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7779
dc.language.isoenen_US
dc.publisherPaediatrics and international child healthen_US
dc.subjectBubble continuous positive airway pressureen_US
dc.subjectLow- and middle-income countriesen_US
dc.subjectGlobal healthen_US
dc.subjectRespiratory supporten_US
dc.subjectInternational healthen_US
dc.subjectChild healthen_US
dc.subjectDevice innovationsen_US
dc.titleUse of a modified bubble continuous positive airway pressure (bCPAP) device for children in respiratory distress in low- and middle-income countries: a safety studyen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Use of a modified bubble continuous positive airway pressure bCPAP device for children in respiratory distress in low and middle income countries a.pdf
Size:
1.18 MB
Format:
Adobe Portable Document Format
Description:
Article
Download
Collections
Medical and Health Sciences