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Published on: July 14, 2023
Innovations and adaptations in neonatal and pediatric respiratory care for resource constrained settings
Andrew Wu1, Mariya Mukhtar-Yola2, Sreyleak Luch3
1Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States.
Insights
Respiratory diseases cause many child deaths globally, especially in low- to middle-income countries (LMICs). Innovations are improving access to advanced respiratory care despite significant resource challenges.
Area of Science:
- Pediatric respiratory medicine
- Global health technology
Background:
- Respiratory diseases are a primary cause of mortality in children under five worldwide.
- Low- to middle-income countries (LMICs) face significant barriers to advanced respiratory care, including cost, personnel, and infrastructure limitations.
- Pediatric respiratory care presents unique challenges due to patient size variability.
Purpose of the Study:
- To review the global burden of pediatric respiratory diseases.
- To highlight innovations in respiratory care technology for LMICs.
- To discuss ongoing technological developments and future innovation needs for resource-constrained settings.
Main Methods:
- Literature review of global respiratory disease burden in children.
- Analysis of existing and emerging respiratory care technologies for LMICs.
- Discussion of challenges and opportunities in pediatric respiratory care innovation.
Main Results:
- Significant global mortality from pediatric respiratory diseases, concentrated in LMICs.
- Numerous technological innovations have enhanced respiratory care access in remote areas.
- Ongoing development of new technologies aims to address resource constraints.
Conclusions:
- Despite substantial barriers, innovations are increasing access to high-quality pediatric respiratory care in LMICs.
- Further innovation is crucial to overcome resource limitations and improve outcomes.
- Addressing infrastructure, cost, and training needs is essential for sustainable respiratory care in LMICs.
Abstract:
Respiratory disease is a leading cause of death in children under 5 years of age worldwide, and most of these deaths occur in low- to middle-income countries (LMICs) where advanced respiratory care technology is often limited. Much of the equipment required to provide advanced respiratory care is unavailable in these areas due to high costs, the need for specialty trained personnel, and myriad other resource constraints that limit uptake and sustainable use of these devices, including reliable access to electricity, sensitive equipment needing frequent maintenance, single-patient-use supplies, and lack of access to sterilization equipment. Compounding the problem, pediatrics is uniquely challenging in that one size does not fit all, or even most patients. Despite these substantial barriers, numerous innovations in respiratory care technology have been made in recent years that have brought increasing access to high quality respiratory care in some of the most remote areas of the world. In this article, we intend to review the global burden of respiratory diseases for children, highlight the prototypical innovations that have been made in bringing respiratory care to LMICs, spotlight some of the technologies being actively developed to improve respiratory care in resource-constrained settings, and conclude with a discussion highlighting areas where further innovation is still needed.
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