Bubble CPAP respiratory support devices for infants in low-resource settings

Area of Science:

• Neonatal medicine
• Global health
• Biomedical engineering

Background:

• Neonatal conditions like hypoxemia and respiratory distress cause nearly half of all under-5 deaths, predominantly in low- and middle-income countries (LMICs).
• Effective noninvasive respiratory support is crucial for reducing neonatal mortality, but its implementation in LMICs faces significant barriers.
• These barriers include infrastructure limitations, equipment shortages, insufficient skilled personnel, high costs, and supply chain issues for consumables and spare parts.

Purpose of the Study:

• To provide a comprehensive evaluation of commercially available noninvasive respiratory support devices for LMICs.
• To focus specifically on bubble continuous positive airway pressure (bCPAP) devices and systems.
• To critically assess the advantages and disadvantages of various bCPAP solutions in low-resource contexts.

Main Methods:

• Review and evaluation of commercially available bCPAP devices suitable for LMICs.
• Description of essential equipment for safe and effective bCPAP administration.
• Critical analysis of different bCPAP system configurations and their suitability for low-resource settings.

Main Results:

• Bubble CPAP (bCPAP) can be delivered using specialized commercial devices or even self-made systems.
• Essential components for bCPAP include reliable air and oxygen sources, pressure-reducing valves, flowmeters, blending systems, humidifiers, patient circuits, and airway interfaces.
• Various existing solutions were critically evaluated for their performance and applicability in LMICs.

Conclusions:

• Implementing noninvasive respiratory support, particularly bCPAP, holds significant potential to decrease neonatal mortality in LMICs.
• Careful selection and evaluation of appropriate bCPAP devices and systems are essential for successful implementation in resource-limited environments.
• Addressing infrastructure, equipment, and supply chain challenges is key to maximizing the impact of bCPAP in LMICs.