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Non-invasive respiratory support for infants in low- and middle-income countries

Erik A Jensen1, Aasma Chaudhary1, Zulfiqar A Bhutta2

  • 1The Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA.

Seminars in Fetal & Neonatal Medicine
|February 27, 2016
PubMed

Insights

Non-invasive respiratory support like bubble CPAP can significantly reduce newborn deaths from respiratory issues and preterm birth complications in low-resource settings. Further research is needed for high-flow nasal cannulae use in these regions.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Care
  • Global Health Equity

Background:

  • Neonatal mortality is disproportionately high in low- and middle-income countries (LMICs).
  • Respiratory illnesses and preterm birth complications are primary causes of neonatal death in LMICs.
  • Non-invasive respiratory support strategies are crucial for improving neonatal outcomes in resource-limited settings.

Purpose of the Study:

  • To evaluate the effectiveness and safety of non-invasive respiratory support for neonates in LMICs.
  • To compare different non-invasive ventilation methods, specifically bubble CPAP versus mechanical ventilator-generated CPAP.
  • To assess the potential role of high-flow nasal cannulae in neonatal care in LMICs.

Main Methods:

  • Review of existing data on non-invasive respiratory support therapies for neonates.
  • Comparative analysis of bubble CPAP and mechanical ventilator-generated CPAP efficacy.
  • Assessment of available evidence on high-flow nasal cannulae in LMIC contexts.

Main Results:

  • Non-invasive continuous positive airway pressure (CPAP) is a safe and cost-effective intervention for reducing neonatal morbidity and mortality in LMICs.
  • Bubble CPAP is associated with a reduced need for subsequent invasive ventilation compared to mechanical ventilator-generated CPAP.
  • Limited data exist on the safety and efficacy of high-flow nasal cannulae in LMICs.

Conclusions:

  • Bubble CPAP is a recommended, effective, and economical therapy for neonatal respiratory distress in LMICs.
  • Further investigation into high-flow nasal cannulae is necessary before widespread adoption in resource-limited neonatal care settings.
  • Improving access to non-invasive respiratory support can substantially decrease preventable neonatal deaths globally.

Keywords:
Continuous positive airway pressureHigh-flow nasal cannulaLow- and middle-incomeLow-resourceRespiratory distress syndrome

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