Bubble NIPPV: Guidelines for Use

Neonatal respiratory distress is a primary contributor to neonatal morbidity and mortality worldwide. Non-invasive respiratory support such as nasal continuous positive airway pressure (NCPAP) and bubble NCPAP (bNCPAP) are often used as the first line of treatment for neonatal respiratory distress, including respiratory distress syndrome; however, many hospitals in low- and middle-income countries do not have access to advanced respiratory support devices beyond NCPAP. A novel, non-invasive bubble positive pressure ventilation device has been developed as a low-cost, non-electric alternative to providing respiratory support in such scenarios. In this article, we propose evidence-based guidelines for the initiation, titration, and weaning of the new device.