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https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#1
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...
July 18, 2017: 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
#2
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
#3
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
#4
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
#5
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...
May 30, 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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27790540/a-randomized-trial-comparing-efficacy-of-bubble-and-ventilator-derived-nasal-cpap-in-very-low-birth-weight-neonates-with-respiratory-distress
#10
Sheetal Agarwal, Arti Maria, Mahesh K Roy, Ankit Verma
INTRODUCTION: Continuous Positive Airway Pressure (CPAP) has an established role in the care of Very Low Birth Weight (VLBW) babies with respiratory distress. Bubble CPAP (BCPAP) is a cheap alternative for countries where resources are limited. However, data comparing efficacy of BCPAP with conventional ventilator derived (VCPAP) is limited. AIM: To compare CPAP failure rates between BCPAP and VCPAP among VLBW, with moderate respiratory distress. Secondary objectives were to compare the rates of Intraventricular Haemorrhage (IVH), pulmonary air leaks and deaths between the two groups and determine the predictors of CPAP failure...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27711045/non-invasive-inhaled-nitric-oxide-in-the-treatment-of-hypoxemic-respiratory-failure-in-term-and-preterm-infants
#11
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
January 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27194606/early-bubble-continuous-positive-airway-pressure-investigating-interprofessional-best-practices-for-the-nicu-team
#12
Jessica L Casey, Desi Newberry, Amy Jnah
Premature neonates delivered <32 completed weeks gestation are unprepared to handle the physiologic demands of extrauterine life. Within the respiratory system, alveolar instability and collapse can cause decreased functional residual capacity, impaired oxygenation, and hypoxemia leading to respiratory distress syndrome. Supportive measures are indicated immediately after birth to establish physiologic stability including bubble continuous positive airway pressure (CPAP) or endotracheal intubation and mechanical ventilation...
2016: Neonatal Network: NN
https://www.readbyqxmd.com/read/27118822/effect-of-treatment-of-premature-infants-with-respiratory-distress-using-low-cost-bubble-cpap-in-a-rural-african-hospital
#13
Jennifer Myhre, Mutisya Immaculate, Bob Okeyo, Matthew Anand, Anastacia Omoding, Luke Myhre, Lilian Okeyo, Immaculate Barasa, Steve Letchford
BACKGROUND: Kenya's neonatal mortality rate remains unacceptably high, at 22 deaths per 1000 live births, with a third of those attributable to prematurity. Respiratory distress syndrome (RDS) is the single most important cause of morbidity and mortality in the premature neonate. Continuous positive airway pressure (CPAP) is a proven modality of therapy but is rarely used in low-resource settings. We report on the introduction of bubble CPAP (BCPAP), a low-cost method of delivering CPAP appropriate to our setting, by comparing survival-to-discharge before and after the technology was introduced...
October 2016: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/27109089/efficacy-and-safety-of-cpap-in-low-and-middle-income-countries
#14
A Thukral, M J Sankar, A Chandrasekaran, R Agarwal, V K Paul
We conducted a systematic review to evaluate the (1) feasibility and efficacy and (2) safety and cost effectiveness of continuous positive airway pressure (CPAP) therapy in low- and middle-income countries (LMIC). We searched the following electronic bibliographic databases-MEDLINE, Cochrane CENTRAL, CINAHL, EMBASE and WHOLIS-up to December 2014 and included all studies that enrolled neonates requiring CPAP therapy for any indication. We did not find any randomized trials from LMICs that have evaluated the efficacy of CPAP therapy...
May 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/26955624/analysis-and-comparison-of-the-effects-of-n-bipap-and-bubble-cpap-in-treatment-of-preterm-newborns-with-the-weight-of-below-1500-grams-affiliated-with-respiratory-distress-syndrome-a-randomised-clinical-trial
#15
Alireza Sadeghnia, Behzad Barekateyn, Zohre Badiei, Seyyed Mohsen Hosseini
BACKGROUND: Nowadays, establishment of nCPAP and surfactant administration is considered to be the first level of intervention for newborns engaged in the process of Respiratory Distress Syndrome (RDS). In order to decrease the side effects of the nCPAP management placed in noninvasive-non-cycled respiratory support. Noninvasive-cycled respiratory support mechanism have been developed such as N-BiPAP. Therefore, we compared N-BiPAP with Bubble-CPAP in a clinical trial. MATERIALS AND METHODS: This research was done as an on newborns weighing less than 1500 grams affiliated with RDS...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/26936186/strategies-for-the-prevention-of-continuous-positive-airway-pressure-failure
#16
REVIEW
Rakesh Sahni, Maria Schiaratura, Richard A Polin
Progress in neonatal intensive care is closely linked to improvements in the management of respiratory failure in preterm infants. Current modalities of respiratory support range from the more benign continuous positive airway pressure (CPAP) to various modes of mechanical ventilation. Data from recent randomized control trials suggest that the use of nasal (n)CPAP as the initial mode of respiratory support in critically ill very low birth weight infants is associated with a lower incidence of chronic lung disease...
June 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26936093/initiating-nasal-continuous-positive-airway-pressure-in-preterm-neonates-at-5-cm-as-against-7-cm-did-not-decrease-the-need-for-mechanical-ventilation
#17
COMPARATIVE STUDY
Srinivas Murki, Prem Prakash Nathani, Deepak Sharma, Sreeram Subramaniam, Tejo Pratap Oleti, Deepak Chawla
AIM: The optimum starting nasal continuous positive airway pressure (nCPAP) for infants on bubble nCPAP is unknown. We compared whether an initial bubble nCPAP of 7 cm rather than 5 cm of water prevented the need for mechanical ventilation among preterm neonates with respiratory distress. METHODS: Preterm neonates born at 27-34 weeks with the onset of respiratory distress within 24 hours of birth were randomised to receive high or standard nCPAP at either 7 cm or 5 cm of water, respectively...
August 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/26915655/non-invasive-respiratory-support-for-infants-in-low-and-middle-income-countries
#18
REVIEW
Erik A Jensen, Aasma Chaudhary, Zulfiqar A Bhutta, Haresh Kirpalani
The overwhelming majority of neonatal deaths worldwide occur in low- and middle-income countries. Most of these deaths are attributable to respiratory illnesses and complications of preterm birth. The available data suggest that non-invasive continuous positive airway pressure (CPAP) is a safe and cost-effective therapy to reduce neonatal morbidity and mortality in these settings. Bubble CPAP compared to mechanical ventilator-generated CPAP reduces the need for subsequent invasive ventilation in newborn infants...
June 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26800273/bubble-cpap-support-after-discontinuation-of-mechanical-ventilation-protects-rat-lungs-with-ventilator-induced-lung-injury
#19
Chun Shan Wu, Hsiu Chu Chou, Liang Ti Huang, Yen Kuang Lin, Chung Ming Chen
BACKGROUND: Bubble continuous positive airway pressure (BCPAP) has been used in neonates with respiratory distress for decades, but its lung-protective effect and underlying mechanism has not been investigated. OBJECTIVES: To test the hypothesis that BCPAP use after extubation decreases lung injury and that alterations to lung nitric oxide synthase (NOS) 3 expression may be one of the underlying mechanisms. METHODS: We compared gas exchange, lung injury severity, and lung NOS expression among rats with ventilator-induced lung injury (VILI) treated with either BCPAP or spontaneous breathing...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/26534997/evaluating-the-effect-of-flow-and-interface-type-on-pressures-delivered-with-bubble-cpap-in-a-simulated-model
#20
Stephanie A Bailes, Kimberly S Firestone, Diane K Dunn, Neil L McNinch, Miraides F Brown, Teresa A Volsko
BACKGROUND: Bubble CPAP, used for spontaneously breathing infants to avoid intubation or postextubation support, can be delivered with different interface types. This study compared the effect that interfaces had on CPAP delivery. We hypothesized that there would be no difference between set and measured levels between interface types. METHODS: A validated preterm infant nasal airway model was attached to the ASL 5000 breathing simulator. The simulator was programmed to deliver active breathing of a surfactant-deficient premature infant with breathing frequency at 70 breaths/min inspiratory time of 0...
March 2016: Respiratory Care
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