Bubble CPAP versus Ventilator CPAP in Preterm Neonates with Early Onset Respiratory Distress--A Randomized Controlled Trial

Tagare, Amit; Vaidya, Umesh; Pandit, Anand; Patole, Sanjay

doi:10.1093/tropej/fms061

Cited by 60 publications

(43 citation statements)

References 22 publications

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“…The RSS has been used in other low-income/middleincome hospitals to guide CPAP treatment, 17,20 and our study suggests this is a reliable tool for hospitals lacking blood gas machines or x-ray capability. However, additional follow-up testing of health-care providers is needed to establish long-term retention of reliable RSS assessment skills, and correlation with blood gas measurements is warranted to establish accuracy in detecting respiratory failure.…”

Section: Discussionmentioning

confidence: 73%

Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU

et al. 2014

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BACKGROUND: Respiratory distress is a leading cause of neonatal death in low-income and middle-income countries. CPAP is a simple and effective respiratory support modality used to support neonates with respiratory failure and can be used in low-income and middle-income countries. The goal of this study was to describe implementation of the Silverman-Andersen respiratory severity score (RSS) and bubble CPAP in a rural Ugandan neonatal NICU. We sought to determine whether physicians and nurses in a low-income/middle-income setting would assign similar RSS in neonates after an initial training period and over time. METHODS: We describe the process of training NICU staff to use the RSS to assist in decision making regarding initiation, titration, and termination of bubble CPAP for neonates with respiratory distress. Characteristics of all neonates with respiratory failure treated with bubble CPAP in a rural Ugandan NICU from January to June 2012 are provided. RESULTS: Nineteen NICU staff members (4 doctors and 15 nurses) received RSS training. After this, the Spearman correlation coefficient for respiratory severity scoring between doctor and nurse was 0.73. Twenty-one infants, all < 3 d of age, were treated with CPAP, with 17 infants starting on the day of birth. The majority of infants (16/21, 76%) were preterm, 10 (48%) were <1,500 g (birthweight), and 13 (62%) were outborn. The most common diagnoses were respiratory distress syndrome (16/21, 76%) and birth asphyxia (5/21, 24%). The average RSS was 7.4 ؎ 1.3 before starting CPAP, 5.2 ؎ 2.3 after 2-4 h of CPAP, 4.9 ؎ 2.7 after 12-24 h of CPAP, and 3.5 ؎ 1.9 before CPAP was discontinued. Duration of treatment with CPAP averaged 79 ؎ 43 h. Approximately half (11/21, 52%) of infants treated with CPAP survived to discharge. CONCLUSIONS: Implementing bubble CPAP in a low-income/middle-income setting is feasible. The RSS may be a simple and useful tool for monitoring a neonate's respiratory status and for guiding CPAP management.

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Section: Discussionmentioning

confidence: 73%

Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU

et al. 2014

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“…Several studies addressed secondary outcomes (reduction in need for mechanical ventilation via an endotracheal tube,37–39 and safety and efficacy of bubble CPAP compared with ventilator-driven CPAP35 40 41), while the largest number were case-series describing practical experience with CPAP, both bubble-based or via other systems 31 32 34 42–48. All studies described the use of CPAP in hospitals, with no studies describing home CPAP.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review

Martin

Duke

Davis

2014

Arch Dis Child Fetal Neonatal Ed

112

122

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“…Martin et al 6 conducted a systematic review of the safety and efficacy of bubble CPAP in neonatal care in low-income and middle-income countries. The majority of studies were case series but they identified four randomised trials, two conducted in India (N=30 and N=114),7 8 one in Iran (N=50)9 and one in South America (N=256) 10. They found no evidence of survival benefit from bubble CPAP in low-income and middle-income countries, but conclude that though the reported studies are limited by poor study design and quality, bubble CPAP appears to be safe and to reduce the need for mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of flow driver and bubble continuous positive airway pressure in preterm infants in a resource-limited setting

Mazmanyan

Mellor²,

Doré

et al. 2015

Arch Dis Child Fetal Neonatal Ed

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Bubble CPAP versus Ventilator CPAP in Preterm Neonates with Early Onset Respiratory Distress--A Randomized Controlled Trial

Abstract: BCPAP has higher success rate than VCPAP for managing preterm neonates with early onset respiratory distress, with comparable safety.

Cited by 60 publications

References 22 publications

Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU

Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU

Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review

A randomised controlled trial of flow driver and bubble continuous positive airway pressure in preterm infants in a resource-limited setting

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