Reported Complications of Bubble Continuous Positive Airway Pressure Systems in Low-Resource Settings: An...

Area of Science:

• Pediatrics
• Critical Care Medicine
• Global Health

Background:

• Lower respiratory tract infections (LRTIs) are a major cause of mortality in young children, particularly in low-resource settings (LRSs).
• Access to commercial respiratory support devices like bubble continuous positive airway pressure (bCPAP) is often limited in LRSs due to cost and maintenance challenges.
• Homemade bCPAP devices, such as the WHO-style design, present a potentially low-cost alternative, but their safety profile requires further investigation.

Purpose of the Study:

• To assess the safety and complication profiles of homemade bCPAP devices used by practitioners in LRSs.
• To compare the incidence of complications, including pneumothorax, between homemade and commercial bCPAP devices.

Main Methods:

• An international survey was conducted among healthcare practitioners in LRSs utilizing homemade bCPAP.
• The survey collected qualitative feedback on various complications experienced with two forms of homemade bCPAP (narrow- and wide-bore expiratory limb).
• Data on complications were compared between homemade and commercial bCPAP usage.

Main Results:

• The survey did not reveal a convincing pattern differentiating the recall of complications between commercial bCPAP and homemade bCPAP (narrow- or wide-bore) in neonates or older children.
• Practitioners' experiences suggested that severe side effects, such as high pressures, are not commonly encountered with homemade bCPAP.

Conclusions:

• Homemade bCPAP devices appear to have a comparable safety profile to commercial devices regarding commonly recalled complications.
• These findings support the potential utility of low-cost, homemade bCPAP solutions in resource-limited environments for managing pediatric LRTIs.
• Further research may be warranted to definitively establish the safety and efficacy of homemade bCPAP in diverse clinical settings.