China
Africa
Explore chapters and articles related to this topic
Acute disorders of the respiratory tract
Published in Janet M Rennie, Giles S Kendall, A Manual of Neonatal Intensive Care, 2013
Janet M Rennie, Giles S Kendall
Although CPAP can be delivered by ETT, double nasal prongs are now the most widely used and safest technique for administering CPAP. Nasal masks are also in common use and may be valuable to provide a ‘rest’ for the nose from prongs. Various devices can be used to provide CPAP. The simplest is to use an underwater seal which provides a bubble CPAP system; most ventilators will have a CPAP mode. Commonly in the UK specifically designed CPAP devices are used which may produce either single or bi-level pressure. During bi-level CPAP two alternating levels of CPAP are delivered which can be syncronized with the baby’s respiratory effort. Theoretically this may recruit unstable alveoli, and the delta pressure generates a tidal volume, potentially reducing respiratory work.
Parental experiences in neonatal intensive care unit in Ethiopia: a phenomenological study
Published in Annals of Medicine, 2022
Endalkachew Worku Mengesha, Desalegne Amare, Likawunt Samuel Asfaw, Mulugeta Tesfa, Mitiku B. Debela, Fentie Ambaw Getahun
This study was conducted in one of the hospitals in Ethiopia from August 1 to 15, 2020. The hospital was established in 1961 and currently provides services for about seven million people. The hospital has seven wards including the NICU. It also has 859 HCPs (133 physicians, 438 nurses, and 56 midwives). Specifically; six physicians and 31 nurses were working in the NICU and there were 83 beds with supportive machines. The NICU service was established as a separate department in February 2015. Currently, the unit comprises Kangaroo Mother Care (KMC) with 8 beds, maternal side with 33 beds, term with 14 cots, preterm room with 20 cots, and septic room with 8 cots. The unit is equipped with 11 radiant warmer machines, 2 heaters, an average of 20 oxygen cylinders per 15 days, four perfusion machines, four electrical continuous positive airway pressure(CPAP), 10 non-electrical CPAP, and two mechanical ventilators. Besides, bubble CPAP prepared using locally available materials like ringer lactate bag, tap water, and oxygen cylinder was used. However, there is no automated CPAP and mechanical ventilator.
High flow nasal cannula in the pediatric intensive care unit
Published in Expert Review of Respiratory Medicine, 2022
Jason A. Clayton, Katherine N. Slain, Steven L. Shein, Ira M. Cheifetz
Chisti and colleagues randomized 225 children with severe pneumonia and hypoxemia to three groups: bubble CPAP, low-flow nasal cannula, and high-flow nasal cannula [56]. Primary outcome was treatment failure defined as two or more of the following: severe hypoxemia (SpO2 < 85%) after 30 minutes of study therapy, signs of severe respiratory distress, and capillary pCO2 greater than 60 mmHg and pH less than 7.2. There were fewer treatment failures and decreased mortality in the group that received bubble CPAP compared to low-flow nasal cannula. No differences in treatment failure were seen when comparing bubble CPAP to HFNC. The study was stopped prematurely because of the increased mortality in the low-flow oxygen group. It is, therefore, not clear if the absence of differences between CPAP and HFNC is true given the underpowered nature of the study.
Effective training-of-trainers model for the introduction of continuous positive airway pressure for neonatal and paediatric patients in Kenya
Published in Paediatrics and International Child Health, 2019
Bernard Olayo, Caroline Kendi Kirigia, Jacquie Narotso Oliwa, Odero Nicholas Agai, Marilyn Morris, Megan Benckert, Steve Adudans, Florence Murila, Patrick T. Wilson
Acute respiratory distress syndrome in neonatal prematurity was the most common indication for CPAP. Bubble CPAP has been used for decades as standard care for neonates and, given the high morbidity and mortality associated with prematurity, it is not unexpected that healthcare providers focused their efforts on them. In this cohort, the mortality rate was extremely high (24%). This may be secondary to clinicians applying CPAP to the sickest neonatal patients because of the limited number of available CPAP machines. Given their overall poor outcome and limited availability of CPAP machines, some institutions avoid the use of CPAP in neonates <1 kg. Providers were trained to wean CPAP in patients who achieved age-appropriate respiratory rates, lacked signs of respiratory distress and required no supplemental oxygen. Thus, a sick patient requiring CPAP for a long time would prevent other patients from receiving it. To maximize the use of resources, further studies are needed to better determine the patients who will derive optimal benefit from CPAP.