Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Neonatal Unit, National Hospital Abuja, Federal Capital Territory, Nigeria.
Paediatr Respir Rev. 2019 Feb;29:31-36. doi: 10.1016/j.prrv.2018.04.004. Epub 2018 May 4.
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.
全球 80%以上的儿童死亡负担发生在中低收入国家（LMIC）。在主要死因中，呼吸衰竭是前三种常见的死因。气泡持续气道正压通气（bCPAP）是一种标准的治疗方法，在高资源环境中被认为是安全且具有成本效益的。尽管来自 LMIC 的高质量试验很少，但结合高收入国家的研究进行综合分析表明，bCPAP：（i）降低死亡率；（ii）减少机械通气的需求；（iii）防止拔管失败。在 LMIC 的医疗保健系统的各个层面更广泛地提供和优化使用 bCPAP 是提高儿童生存率的重要步骤。需要开展研究，以在资源有限的 LMIC 环境中有效地实施和维持 bCPAP 的安全使用。
