Related Experiment Video
Updated: Dec 30, 2025
Artificial Lung Device Priming for In Situ Fiber Bundle Surface Grafting
Published on: March 28, 2025
An experience with a bubble CPAP bundle: is chronic lung disease preventable?
Hany Aly1,2, Mohamed A Mohamed3
1The George Washington University Hospital, Washington, DC, USA.
Insights
A bubble CPAP (b-CPAP) bundle of care effectively reduced chronic lung disease (CLD) in preterm infants. This approach is feasible and sustainable, showing lower CLD rates compared to benchmarks.
Area of Science:
- Neonatalogy
- Pediatric Pulmonology
- Critical Care Medicine
Background:
- Continuous positive airway pressure (CPAP) offers a marginal decrease in chronic lung disease (CLD).
- Preterm infants often require respiratory support, increasing risks for CLD.
- A bubble CPAP (b-CPAP) bundle of care is a potential strategy to mitigate CLD.
Purpose of the Study:
- To evaluate the outcomes, specifically CLD incidence, in preterm infants managed with a b-CPAP bundle.
- To assess the feasibility and sustainability of the b-CPAP bundle in a clinical setting.
- To compare CLD rates with historical data and external benchmarks.
Main Methods:
- Infants under 1500g were grouped by intubation status within the first 3 days of life.
- Mortality, CLD, and other morbidities were analyzed across four chronological periods.
- Outcomes from the most recent period were compared to Vermont Oxford Network (VON) data.
Main Results:
- Out of 773 infants, 24.5% required intubation in the delivery room.
- The overall incidence of CLD was 6.4%, remaining consistent across epochs.
- CLD rates were significantly lower compared to VON benchmarks (p < 0.001).
Conclusions:
- A b-CPAP bundle of care is a feasible and sustainable method to reduce CLD in preterm infants.
- The study demonstrated significantly lower CLD rates compared to established benchmarks.
- Further cluster randomized trials are recommended to confirm the reproducibility of this b-CPAP approach.
Background:
Continuous positive airway pressure (CPAP) is associated with marginal decrease in chronic lung disease (CLD). This study aims to report outcomes, with focus on CLD, of preterm infants managed with a bubble CPAP (b-CPAP) bundle of care.
Methods:
Infants <1500 g were stratified into four groups depending on intubation status through first 3 days of life. The incidence of mortality, CLD and other morbidities were compared over four chronological epochs. Outcomes of the most recent epoch were compared to contemporaneous benchmarks from Vermont Oxford Network (VON).
Results:
Of 773 infants (median GA = 28 weeks, average BW = 995 g), 24.5% were intubated in DR and 11.7% in the first day of life. Mechanical ventilation, bCPAP and oxygen days in survivors were 1.5, 29 and 14, respectively. Overall incidence of CLD was 6.4% that remained consistent in the four epochs (7.6%, 7.5%, 5.8% and 5%), respectively. In comparison to VON, CLD was significantly less (p < 0.001). Initial DR intubation was not associated with increased CLD compared to initial management with CPAP that required subsequent intubation.
Conclusion:
It is feasible and sustainable to administer a b-CPAP bundle of care to decrease CLD. Cluster randomized trials are needed to validate the reproducibility of this approach.
More Related Videos
07:10Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
04:03Author Spotlight: Evaluating the Therapeutic Efficacy of Moving Cupping Along Meridians for Acute Exacerbation of COPD
Published on: September 27, 2024
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management