Feasibility of a novel ultra-low-cost bubble CPAP (bCPAP) System for neonatal respiratory support at Muhimbili National Hospital, Tanzania

Abstract

Objective Continuous Positive Airway Pressure (CPAP) is recommended in the treatment of respiratory distress syndrome of premature newborns, however there are significant barriers to its implementation in low-resource settings. The objective of this study was to evaluate the feasibility of use and integration of Vayu bCPAP Systems into the newborn unit at Muhimbili National Hospital in Tanzania. Study design A prospective qualitative study was conducted from April 6 to October 6 2021. Demographic and clinical characteristics of patients treated with Vayu bCPAP Systems were collected and analyzed. Healthcare workers were interviewed until thematic saturation. Interviews were transcribed, coded, and analyzed using a framework analysis. Results 370 patients were treated with Vayu bCPAP Systems during the study period. Mean birth weight was 1522 g (500–3800), mean duration of bCPAP treatment was 7.2 days (<1–39 d), and survival to wean was 81.4%. Twenty-four healthcare workers were interviewed and perceived Vayu bCPAP Systems as having become essential for treating neonatal respiratory distress at MNH. Key reasons were that Vayu bCPAP Systems improve patient outcomes, are easy to use, and more patients are now able to receive quality care. Barriers to integration included durability of oxygen tubing material and training. Conclusions It was feasible to implement and integrate Vayu bCPAP Systems into the care of neonates at Muhimbili National Hospital.

Vayu bubble continuous positive airway pressure is a promising solution with favorable treatment outcomes for respiratory distress syndrome in newborns: a qualitative study in Bangladesh

“…The technical simplicity and easy bedside portability and assembly of the device enhanced the early initiation of respiratory support in SCANU settings and increased the service acceptability of the new device. These study results are generally consistent with the findings of other studies conducted in other similar settings around the world ( 16 – 19 ).…”

Antenatal corticosteroids reduce neonatal mortality in settings without assisted ventilatory support: a retrospective cohort study of early preterm births on the Thailand-Myanmar border

“…Hence this study, unlike the review by Pattanittum et al ., 16 excluded infants born in hospital to maintain a focus on those likely to derive benefit from dexamethasone. Given the challenges in scaling up even bubble CPAP use in low resource settings 40 , this study is novel as it demonstrates that a complete course of dexamethasone with no assisted ventilation reduced neonatal mortality in early PTB.…”