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Improvised bubble continuous positive airway pressure ventilation use in neonates in resource-limited settings: a

Fatima Usman1, Zubaida L Farouk1, Fatimah I Tsiga-Ahmed2

  • 1Department of Pediatrics, Bayero University, Kano & Aminu Kano Teaching Hospital, Kano, Nigeria.

Journal of Perinatal Medicine
|March 9, 2022
PubMed

Insights

Improvised bubble continuous positive airway pressure (ibCPAP) in low-resource settings improved neonates' oxygen saturation and reduced oxygen duration. However, ibCPAP did not significantly impact respiratory rate, admission length, mortality, or survival rates.

Area of Science:

  • Neonatal respiratory support
  • Low-resource healthcare innovations
  • Public health in developing nations

Background:

  • Limited resources necessitate improvised solutions for neonatal respiratory distress in low- and middle-income countries (LMICs).
  • Neonatal mortality from respiratory complications remains a significant challenge in LMICs.
  • Effective and sustainable ventilatory support is crucial for improving neonatal outcomes.

Purpose of the Study:

  • To assess the utilization of improvised bubble continuous positive airway pressure (ibCPAP) in LMICs.
  • To determine the impact of ibCPAP on neonatal respiratory outcomes in LMICs.
  • To evaluate the effectiveness of ibCPAP in reducing neonatal mortality associated with respiratory complications.

Main Methods:

  • Systematic review of hospital-based studies from 2010-2020 in LMICs.
  • Screening and selection of articles using Rayyan® software.
  • Statistical analysis using Stata® to estimate pooled prevalence, proportion estimates, and weighted mean differences with 95% Confidence Intervals (CI) via random effects model.

Main Results:

  • 13 articles involving 806 neonates using ibCPAP were included; pooled prevalence was 7.0% (95% CI: 3.0%-13.0%).
  • Significant improvement in mean oxygen saturation post-ibCPAP use (-1.34%; 95% CI: -1.65% to -1.02%, p<0.01).
  • Reduced duration of oxygen requirement by 6.5 hours (0.27 days; 95% CI: -0.49 to -0.05, p<0.01).

Conclusions:

  • Improvised bubble CPAP (ibCPAP) use in LMIC hospitals is currently low.
  • ibCPAP positively impacts oxygen saturation and reduces the duration of oxygen dependency in neonates.
  • ibCPAP demonstrated no significant effect on respiratory rate, duration of admission, mortality, or survival.
Abstract

Keywords:
LMICs, resource-limited countriesibCPAPimprovised bubble continuous positive airway pressurelow-cost bubble continuous positive airway pressurerespiratory support

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