Non-invasive ventilation with bubble CPAP is feasible and improves respiratory physiology in hospitalised Malawian children with acute respiratory failure

J. Walk, P. Dinga, C. Banda, T. Msiska, E. Chitsamba, N. Chiwayula, N. Lufesi, R. Mlotha-Mitole, A. Costello, A. Phiri, T. Colbourn, Eric McCollum, H. J. Lang

Research output: Contribution to journalArticle

Abstract

Background: In low-income countries and those with a high prevalence of HIV, respiratory failure is a common cause of death in children. However, the role of non-invasive ventilation with bubble continuous positive airway pressure (bCPAP) in these patients is not well established. Methods: A prospective observational study of bCPAP was undertaken between July and September 2012 in 77 Malawian children aged 1 week to 14 years with progressive acute respiratory failure despite oxygen and antimicrobial therapy. Results: Forty-one (53%) patients survived following bCPAP treatment, and an HIV-uninfected single-organ disease subgroup demonstrated bCPAP success in 14 of 17 (82%). Compared with children aged ≥60 months, infants of 0–2 months had a 93% lower odds of bCPAP failure (odds ratio 0.07, 95% confidence interval 0.004–1.02, P = 0.05). Following commencement of bCPAP, respiratory physiology improved, the average respiratory rate decreased from 61 to 49 breaths/minute (P = 0.0006), and mean oxygen saturation increased from 92.1% to 96.1% (P = 0.02). Conclusions: bCPAP was well accepted by caregivers and patients and can be feasibly implemented into a tertiary African hospital with high-risk patients and limited resources.

Original languageEnglish (US)
Pages (from-to)28-33
Number of pages6
JournalPaediatrics and international child health
Volume36
Issue number1
DOIs
StatePublished - 2016

Keywords

  • Bubble continuous airway pressure (bCPAP)
  • HIV
  • Pneumonia
  • Respiratory disorders
  • Respiratory failure

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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