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Laryngeal Mask Airway (LMA) Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway (SGA)
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Laryngeal Mask Airway (LMA) Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway (SGA)

Published on: July 14, 2023

An evaluation of bubble-CPAP in a neonatal unit in a developing country: effective respiratory support that can be

Lanieta Koyamaibole1, Joseph Kado, Josaia D Qovu

  • 1Colonial War Memorial Hospital, Suva, Fiji.

Journal of Tropical Pediatrics
|December 6, 2005
PubMed

To describe the implementation of bubble-CPAP in a referral hospital in a developing country and to investigate: the feasibility of nurses implementing bubble-CPAP and the impact of bubble-CPAP on need for mechanical ventilation and mortality. Retrospective evaluation of prospectively collected data from two time periods: 18 months before and 18 months after the introduction of bubble-CPAP. The introduction of bubble-CPAP was associated with a 50 per cent reduction in the need for mechanical ventilation; from 113 of 1,106 (10.2 per cent) prior to bubble-CPAP to 70 of 1,382 (5.1%) after introduction of CPAP (chi2, p<0.001). In the 18 months prior to bubble-CPAP there were 79 deaths (case fatality of 7.1 per cent). In the 18 months after bubble-CPAP there were 74 deaths (CF 5.4 per cent), relative risk: 0.75 (0.55-1.02, chi2, p=0.065). Nurses could safely apply bubble-CPAP after 1-2 months of on-the-job training. Equipment for Bubble-CPAP cost 15 per cent of the cost of the cheapest mechanical ventilator. The introduction of bubble-CPAP substantially reduced the need for mechanical ventilation, with no difference in mortality. In models of neonatal care for resource-limited countries, bubble-CPAP may be the first type of ventilatory support that is recommended. Its low cost and safety when administered by nurses makes it ideal for this purpose. Bubble-CPAP has the potential for being available at even lower cost than the current commercially available bubble systems used in this study.

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