Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries

Ekhaguere, Osayame A.; Mairami, Amsa B.; Kirpalani, Haresh

doi:10.1016/j.prrv.2018.04.004

Cited by 42Neonatal Respiratory Health ResearchRespiratory Support and MechanismsNeuroscience of respiration and sleep

Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries

Ekhaguere, Osayame A., Mairami, Amsa B., Kirpalani, Haresh·2019·Paediatric Respiratory Reviews

DOI 10.1016/j.prrv.2018.04.004

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Abstract

Over 80% of the global burden of childhood deaths occur in Low- and Middle-Income Countries (LMIC). Of the leading causes of death, respiratory failure is common to the top three. Bubble Continuous Positive Airway Pressure (bCPAP) is a standard therapy considered safe and cost effective in high resource settings. Although high-quality trials from LMIC are few, pooled available trial data considered alongside studies from high-income countries suggest that bCPAP: (i) reduces mortality; (ii) reduces the need for mechanical ventilation; and (iii) prevents extubation failure. Wider availability and optimal use at all levels of the health care system in LMIC are important steps to improve childhood survival. Studies aimed at effectively implementing, and sustaining safe use of bCPAP in the resource limited setting of LMIC are required.

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Preterm and term newborns with respiratory distress can often be effectively supported with CPAP, avoiding the need for intubation and mechanical ventilation.
“Preterm and term newborns with respiratory distress can often be effectively supported with Continuous Positive Airway Pressure (CPAP), avoiding the need for intubation and mechanical ventilation [6,9,10].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [6]
Limited healthcare infrastructure, including lack of equipment and skilled personnel, may compromise effective use of bubble CPAP in neonatal nurseries.
“Limited healthcare infrastructure, including lack of equipment and skilled personnel, may compromise effective use of bubble CPAP in neonatal nurseries [6,12,13,15].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [6]
Bubble CPAP is a simple and relatively inexpensive form of CPAP that may be safe and cost-effective for delivering CPAP and reducing neonatal mortality in LMICs.
“Bubble CPAP is a simple and relatively inexpensive form of CPAP [8,11].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [6]
Many preterm neonates develop respiratory distress and subsequent respiratory failure, contributing to high neonatal mortality.
“Many preterm neonates develop respiratory distress and subsequent respiratory failure, contributing to high neonatal mortality [5,6].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [6]
High-quality research on effective, safe, and sustainable implementation of bubble CPAP in LMICs is required.
“High-quality research studies on effective, safe, and sustainable implementation of bubble CPAP in LMICs are required [6,12].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [6]

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Additional file 5 of Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis
de Jesus Brito, S., Tsopanoglou, S. P., Galvão, E. L., de Deus, F. Â., & de Lima, V. P. (2021) · Figshare · doi:10.6084/m9.figshare.16633160
Additional file 6 of Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis
de Jesus Brito, S., Tsopanoglou, S. P., Galvão, E. L., de Deus, F. Â., & de Lima, V. P. (2021) · Figshare · doi:10.6084/m9.figshare.16633163
Additional file 2 of Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis
de Jesus Brito, S., Tsopanoglou, S. P., Galvão, E. L., de Deus, F. Â., & de Lima, V. P. (2021) · Figshare · doi:10.6084/m9.figshare.16633151
Additional file 1 of Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis
de Jesus Brito, S., Tsopanoglou, S. P., Galvão, E. L., de Deus, F. Â., & de Lima, V. P. (2021) · Figshare · doi:10.6084/m9.figshare.16633148
Additional file 3 of Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis
de Jesus Brito, S., Tsopanoglou, S. P., Galvão, E. L., de Deus, F. Â., & de Lima, V. P. (2021) · Figshare · doi:10.6084/m9.figshare.16633154
Additional file 4 of Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis
de Jesus Brito, S., Tsopanoglou, S. P., Galvão, E. L., de Deus, F. Â., & de Lima, V. P. (2021) · Figshare · doi:10.6084/m9.figshare.16633157

To Bubble or Not? A Systematic Review of Bubble Continuous Positive Airway Pressure in Children in Low- and Middle-Income Countries
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Bubble CPAP may be safe and efficacious for neonates in low and middle income countries, but more evidence is needed
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Feasibility of bubble continuous positive airway pressure in secondary facilities in low and middle income countries
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G494(P) The use of bubble continuous positive airway pressure (bCPAP) for critically ill children in Lilongwe, Malawi
Myers, S., Lang, H., McCollum, E. D., Mlotha-Mitole, R., Phiri, A., Dinga, P., & Colbourne, T. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2016-310863.481 · Cited by 1 · see citing works

Authors: Ekhaguere, O. A., Mairami, A. B., & Kirpalani, H.
Affiliations: Children's Hospital of Philadelphia (US)
National Hospital Abuja (NG)
Corresponding author: Ekhaguere, Osayame A.
ORCID: Ekhaguere, Osayame A.
Kirpalani, Haresh
Venue: Paediatric Respiratory Reviews
Publisher: Elsevier BV
Published: 2019-02
Volume: 29
Pages: 31-36
ISSN: 1526-0542 (ISSN-L)
DOI: 10.1016/j.prrv.2018.04.004
OpenAlex: W2799450995
Cited by: 42
References: 61
Citations by year: 2025: 4 · 2024: 2 · 2023: 5 · 2022: 9 · 2021: 11 · 2020: 6 · 2019: 4 · 2018: 1
FWCI: 0.98
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Paediatric Respiratory Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords: bubble continuous positive airway pressure, neonatal respiratory distress syndrome, low- and middle-income countries, mortality reduction, extubation failure, mechanical ventilation, resource-limited settings
MeSH terms: Cannula, Child, Preschool, Cost-Benefit Analysis, Developing Countries, Humans, Infant, Infant, Newborn, Respiratory Distress Syndrome, Newborn, Respiratory Insufficiency, Risk Assessment, Continuous Positive Airway Pressure

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Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries

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