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https://www.readbyqxmd.com/read/29768512/infant-cpap-for-low-income-countries-an-experimental-comparison-of-standard-bubble-cpap-and-the-pumani-system
#1
Markus Falk, Snorri Donaldsson, Thomas Drevhammar
INTRODUCTION: Access to inexpensive respiratory support to newborn infants improves survival in low-income countries. Standard bubble continuous positive airway pressure (CPAP) has been extensively used worldwide for more than 30 years. One project aimed at providing affordable CPAP is the Pumani system developed by Rice 360°. Compared to standard bubble CPAP the system has an unconventional design. The aim was to compare the Pumani system with two traditional bubble CPAP systems, focusing on in-vitro performance and safety...
2018: PloS One
https://www.readbyqxmd.com/read/29746270/evidence-regarding-the-use-of-bubble-continuous-positive-airway-pressure-in-the-extremely-low-birth-weight-infant-benefits-challenges-and-implications-for-nursing-practice
#2
Samantha Alessi
BACKGROUND: Gentle ventilation with optimal oxygenation is integral to prevention of chronic lung disease in the extremely low birth-weight (ELBW) infant. Various types of noninvasive ventilation are used in neonatal intensive care units worldwide. Bubble continuous positive airway pressure (BCPAP) has been in use in newborn intensive care since 1975. PURPOSE: To synthesize the current evidence on the use of BCPAP in the ELBW infant and its relationship to outcomes, particularly morbidity and mortality...
May 9, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29590143/short-term-evaluation-of-respiratory-effort-by-premature-infants-supported-with-bubble-nasal-continuous-airway-pressure-using-seattle-pap-and-a-standard-bubble-device
#3
Stephen E Welty, Craig G Rusin, Larissa I Stanberry, George T Mandy, Alfred L Gest, Jeremy M Ford, Carl H Backes, C Peter Richardson, Christopher R Howard, Thomas N Hansen, Charles V Smith
BACKGROUND: Almost one million prematurely born infants die annually from respiratory insufficiency, predominantly in countries with limited access to respiratory support for neonates. The primary hypothesis tested in the present study was that a modified device for bubble nasal continuous positive airway pressure (Bn-CPAP) would provide lower work of spontaneous breathing, estimated by esophageal pressure-rate products. METHODS: Infants born <32 weeks gestation and stable on Bn-CPAP with FiO2 <0...
2018: PloS One
https://www.readbyqxmd.com/read/29514813/evaluation-of-try-an-algorithm-for-neonatal-continuous-positive-airways-pressure-in-low-income-settings
#4
Caroline Crehan, Tim Colbourn, Michelle Heys, Elizabeth Molyneux
BACKGROUND: Non-invasive respiratory support using bubble continuous positive airway pressure (bCPAP) is useful in treating babies with respiratory distress syndrome. Despite its proven clinical and cost-effectiveness, implementation is hampered by the inappropriate administration of bCPAP in low-resource settings. A clinical algorithm-'TRY' (based on Tone: good; Respiratory distress; Yes, heart rate above 100 beats/min)-has been developed to correctly identify which newborns would benefit most from bCPAP in a teaching hospital in Malawi...
March 7, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29382795/evaluation-of-a-low-cost-bubble-cpap-system-designed-for-resource-limited-settings
#5
Desmond J Bennett, Ryan W Carroll, Robert M Kacmarek
BACKGROUND: 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...
April 2018: Respiratory Care
https://www.readbyqxmd.com/read/29325421/effects-of-underwater-bubble-cpap-on-very-low-birth-weight-preterm-newborns-in-the-delivery-room-and-after-transport-to-the-neonatal-intensive-care-unit
#6
Vera Lucia Barros Abelenda, Tania Cristina Oliveira Valente, Cirlene Lima Marinho, Agnaldo José Lopes
The development of less invasive ventilatory strategies in very-low-birth-weight (VLBW) preterm newborns has been a growing concern in recent decades. This study aimed to measure differences in the clinical progression of preterm newborns using two distinct periods in a university hospital: before and after using underwater bubble continuous positive airway pressure (ubCPAP). This is a retrospective study of VLBW preterm newborns with gestational ages less than or equal to 32 weeks admitted to the neonatal intensive care unit...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29210760/a-pilot-study-of-responses-to-suctioning-among-neonates-on-bubble-nasal-continuous-positive-airway-pressure
#7
Michele Sweet, Debra Armbruster, Erin Bainbridge, Brianna Reiner, Alai Tan, Esther Chipps
BACKGROUND: Maintenance of a patent airway while the neonate is on nasal continuous positive airway pressure (nasal CPAP) requires vigilant monitoring and oral/nasopharyngeal suctioning. Currently, no evidence-based guidelines for safe suctioning in neonates while on bubble nasal CPAP have been published. PURPOSE: (1) To characterize the clinical and behavioral responses of neonates on bubble nasal CPAP in a level III neonatal intensive care unit following routine oral and nasopharyngeal suctioning...
December 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#8
Aakash Pandita, Srinivas Murki, Tejo Pratap Oleti, Baswaraj Tandur, Sai Kiran, Sachin Narkhede, Amrut Prajapati
Importance: Nasal continuous positive airway pressure (NCPAP) as a primary respiratory therapy in meconium aspiration syndrome (MAS) has not been studied extensively. Nasal continuous positive airway pressure, when applied in newborns with MAS, may resolve atelectasis by sufficiently expanding partially obstructed small airways and stabilizing the collapsing terminal airways to enhance oxygen exchange. Objective: To compare NCPAP vs standard care in neonates with moderate to severe respiratory failure due to MAS in reducing the need for invasive ventilation...
February 1, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/28914355/nasal-injury-and-comfort-with-jet-versus-bubble-continuous-positive-airway-pressure-delivery-systems-in-preterm-infants-with-respiratory-distress
#9
Jafar Khan, Venkataseshan Sundaram, Srinivas Murki, Anuj Bhatti, Shiv Sajan Saini, Praveen Kumar
Nasal injuries with use of nasal continuous positive airway pressure (CPAP) range from blanching of nasal tip to septal necrosis and septal drop. This analysis was done in preterm neonates of < 34-week gestation, who received nasal CPAP as primary support as part of a randomized trial comparing Jet device with Bubble device for delivery of CPAP, both through nasal prongs of different structure, make and fixation methods. Nasal injury was assessed using a validated nasal injury score. Out of 170 neonates enrolled, 103 (61%) had nasal injuries; moderate and severe injuries were observed in 18 (11%) and 8 (5%) infants, respectively...
December 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28883928/cpap-impact-a-protocol-for-a-randomised-trial-of-bubble-continuous-positive-airway-pressure-versus-standard-care-for-high-risk-children-with-severe-pneumonia-using-adaptive-design-methods
#10
Andrew G Smith, Michelle Eckerle, Tisungane Mvalo, Brian Weir, Francis Martinson, Alfred Chalira, Norman Lufesi, Innocent Mofolo, Mina Hosseinipour, Eric D McCollum
INTRODUCTION: Pneumonia is a leading cause of mortality among children in low-resource settings. Mortality is greatest among children with high-risk conditions including HIV infection or exposure, severe malnutrition and/or severe hypoxaemia. WHO treatment recommendations include low-flow oxygen for children with severe pneumonia. Bubble continuous positive airway pressure (bCPAP) is a non-invasive support modality that provides positive end-expiratory pressure and oxygen. bCPAP is effective in the treatment of neonates in low-resource settings; its efficacy is unknown for high-risk children with severe pneumonia in low-resource settings...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28754002/pediatric-respiratory-support-technology-and-practices-a-global-survey
#11
Amélie O von Saint André-von Arnim, Shelina M Jamal, Grace C John-Stewart, Ndidiamaka L Musa, Joan Roberts, Larissa I Stanberry, Christopher R A Howard
OBJECTIVE: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. METHODS: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. RESULTS: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC)...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#12
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
January 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28698327/bubble-continuous-positive-airway-pressure-in-the-treatment-of-severe-paediatric-pneumonia-in-malawi-a-cost-effectiveness-analysis
#13
Teresa Bleakly Kortz, Benjamin Herzel, Elliot Marseille, James G Kahn
OBJECTIVES: Pneumonia is the largest infectious cause of death in children under 5 years globally, and limited resource settings bear an overwhelming proportion of this disease burden. Bubble continuous positive airway pressure (bCPAP), an accepted supportive therapy, is often thought of as cost-prohibitive in these settings. We hypothesise that bCPAP is a cost-effective intervention in a limited resource setting and this study aims to determine the cost-effectiveness of bCPAP, using Malawi as an example...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28569202/a-health-partnership-to-reduce-neonatal-mortality-in-four-hospitals-in-rwanda
#14
Placide Ntigurirwa, Kathy Mellor, Daniel Langer, Mari Evans, Emily Robertson, Lisine Tuyisenge, Alan Groves, Tom Lissauer
BACKGROUND: A health partnership to improve hospital based neonatal care in Rwanda to reduce neonatal mortality was requested by the Rwandan Ministry of Health. Although many health system improvements have been made, there is a severe shortage of health professionals with neonatal training. METHODS: Following a needs assessment, a health partnership grant for 2 years was obtained. A team of volunteer neonatologists and paediatricians, neonatal nurses, lactation consultants and technicians with experience in Rwanda or low-income countries was assembled...
June 1, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28567190/experiences-of-caregivers-of-infants-who-have-been-on-bubble-continuous-positive-airway-pressure-at-queen-elizabeth-central-hospital-malawi-a-descriptive-qualitative-study
#15
Mtisunge Joshua Gondwe, Belinda Gombachika, Maureen D Majamanda
BACKGROUND: An innovative, low-cost bubble continuous positive airway pressure (bCPAP) device has recently been introduced in Malawi for the treatment of respiratory distress in infants. While this novel bCPAP system has been shown to be safe and effective in reducing infant mortality, caregivers' experiences have not been investigated. The purpose of this study was to explore experiences of parents and guardians of infants who had been on bCPAP at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi...
March 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28559463/development-and-testing-of-a-bubble-bi-level-positive-airway-pressure-system
#16
Stephen C John, Joseph D Barnett, Nickolas D Habben, Hoa T Le, Eric Cheng, Sunil P John, Peter A Gustafson
BACKGROUND: Neonatal respiratory distress results in > 1 million annual deaths worldwide. Bubble CPAP is a simple, effective, and widely used therapy for infants in respiratory distress. In low-resource settings, more advanced respiratory support is limited by cost, technical expertise, and sporadic electricity. We sought to develop a safe, inexpensive, and simple solution to provide further respiratory support for these infants. METHODS: A standard bubble CPAP system was modified to provide 2 levels of positive airway pressure (bi-level positive airway pressure) by attaching a novel device...
September 2017: Respiratory Care
https://www.readbyqxmd.com/read/28504495/early-use-of-continuous-positive-airway-pressure-in-the-treatment-of-moderate-to-severe-acute-lower-respiratory-tract-infections-among-patients-younger-than-2-years-old
#17
Laura Figueroa, Federico Laffaye
OBJETIVE: To analyze the characteristics of patients younger than 2 years old who had a moderate to severe acute lower respiratory tract infection and were treated early with bubble continuous positive airway pressure, and factors associated with a successful intervention. METHOD: Retrospective and descriptive study. Children younger than 2 years old admitted to the Pediatric Intermediate Care Unit of Hospital Provincial Neuquen between June 2009 and December 2010...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28157810/bayes-to-the-rescue-continuous-positive-airway-pressure-has-less-mortality-than-high-flow-oxygen
#18
COMPARATIVE STUDY
Vicent Modesto I Alapont, Robinder G Khemani, Alberto Medina, Pablo Del Villar Guerra, Alfred Molina Cambra
OBJECTIVES: The merits of high-flow nasal cannula oxygen versus bubble continuous positive airway pressure are debated in children with pneumonia, with suggestions that randomized controlled trials are needed. In light of a previous randomized controlled trial showing a trend for lower mortality with bubble continuous positive airway pressure, we sought to determine the probability that a new randomized controlled trial would find high-flow nasal cannula oxygen superior to bubble continuous positive airway pressure through a "robust" Bayesian analysis...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28091776/nasal-masks-or-binasal-prongs-for-delivering-continuous-positive-airway-pressure-in-preterm-neonates-a-randomised-trial
#19
RANDOMIZED CONTROLLED TRIAL
Aparna Chandrasekaran, Anu Thukral, M Jeeva Sankar, Ramesh Agarwal, Vinod K Paul, Ashok K Deorari
The objective of this study was to compare the efficacy and safety of continuous positive airway pressure (CPAP) delivered using nasal masks with binasal prongs. We randomly allocated 72 neonates between 26 and 32 weeks gestation to receive bubble CPAP by either nasal mask (n = 37) or short binasal prongs (n = 35). Primary outcome was mean FiO2 requirement at 6, 12 and 24 h of CPAP initiation and the area under curve (AUC) of FiO2 against time during the first 24 h (FiO2 AUC0-24). Secondary outcomes were the incidence of CPAP failure and nasal trauma...
March 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27895847/efficacy-of-a-low-cost-bubble-cpap-system-in-treatment-of-respiratory-distress-in-a-neonatal-ward-in-malawi
#20
Kondwani Kawaza, Heather E Machen, Jocelyn Brown, Zondiwe Mwanza, Suzanne Iniguez, Al Gest, E O'Brian Smith, Maria Oden, Rebecca R Richards-Kortum, Elizabeth Molyneux
BACKGROUND: Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
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