Journal of Tropical Pediatrics Advance Access originally published online on December 2, 2005
Journal of Tropical Pediatrics 2006 52(4):249-253; doi:10.1093/tropej/fmi109
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
An Evaluation of Bubble-CPAP in a Neonatal Unit in a Developing Country: Effective Respiratory Support That Can Be Applied By Nurses
a Colonial War Memorial Hospital, Suva, Fiji
b Centre for International Child Health, Melbourne University Department of Paediatrics, Royal Children's Hospital, Parkville, 3052, Victoria, Australia
Correspondence: Dr Trevor Duke Centre for International Child Health, Department of Paediatrics, Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052 Australia. E-mail <trevor.duke{at}rch.org.au>.
To describe the implementation of bubble-CPAP in a referral hospital in a developing country and to investigate: the feasibility of nurses implementing bubble-CPAP and the impact of bubble-CPAP on need for mechanical ventilation and mortality. Retrospective evaluation of prospectively collected data from two time periods: 18 months before and 18 months after the introduction of bubble-CPAP. The introduction of bubble-CPAP was associated with a 50 per cent reduction in the need for mechanical ventilation; from 113 of 1106 (10.2 per cent) prior to bubble-CPAP to 70 of 1382 (5.1%) after introduction of CPAP (
2, p<0.001). In the 18 months prior to bubble-CPAP there were 79 deaths (case fatality of 7.1 per cent). In the 18 months after bubble-CPAP there were 74 deaths (CF 5.4 per cent), relative risk: 0.75 (0.55–1.02, 2, p=0.065). Nurses could safely apply bubble-CPAP after 1–2 months of on-the-job training. Equipment for Bubble-CPAP cost 15 per cent of the cost of the cheapest mechanical ventilator. The introduction of bubble-CPAP substantially reduced the need for mechanical ventilation, with no difference in mortality. In models of neonatal care for resource-limited countries, bubble-CPAP may be the first type of ventilatory support that is recommended. Its low cost and safety when administered by nurses makes it ideal for this purpose. Bubble-CPAP has the potential for being available at even lower cost than the current commercially available bubble systems used in this study.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Tagare, S. Kadam, U. Vaidya, A. Pandit, and S. Patole A Pilot Study of Comparison of BCPAP vs. VCPAP in Preterm Infants with Early Onset Respiratory Distress J Trop Pediatr, October 20, 2009; (2009) fmp092v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Nowadzky, A. Pantoja, and J. R. Britton Bubble Continuous Positive Airway Pressure, A Potentially Better Practice, Reduces the Use of Mechanical Ventilation Among Very Low Birth Weight Infants With Respiratory Distress Syndrome Pediatrics, June 1, 2009; 123(6): 1534 - 1540. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kugelman International Perspectives: Nasal Ventilation in Preterm Infants: An Israeli Perspective NeoReviews, April 1, 2009; 10(4): e157 - e165. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Gunlemez and T Isken Bubble CPAP must be used with care to avoid harm Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2008; 93(2): F170 - F171. [Full Text] [PDF]
|
|