Egesa Walufu Ivan, Waibi William Mugowa
Department of Paediatrics and Child Health, Faculty of Clinical Medicine and Dentistry, Kampala International University, P.O. Box 20000 Kampala, Uganda.
Int J Pediatr. 2020 Sep 8;2020:8871980. doi: 10.1155/2020/8871980. eCollection 2020.
Preterm birth complications are responsible for almost one-third of the global neonatal mortality burden, and respiratory distress syndrome remains the single most common cause of these preventable deaths. Since its inception, almost half a century ago, nasal continuous positive airway pressure (NCPAP) has evolved to become the primary modality for neonatal respiratory care in both the developed and developing world. Although evidence has demonstrated the effectiveness of low-cost bubble NCPAP in reducing newborn mortality, its widespread use is yet to be seen in resource-constrained settings. Moreover, many tertiary hospitals in developing countries still utilise an inexpensive locally assembled bNCPAP system of unknown efficacy and safety. This review provides a brief overview of the history, physiological benefits, indications, contraindications, and complications of bNCPAP. Evidence regarding the effectiveness of low-cost bNCPAP in the neonatal intensive care unit is also summarised. The article further details a locally assembled bNCPAP system used in resource-constrained settings and highlights the care package for neonates receiving bNCPAP, failure criteria, and strategies for weaning.
早产并发症几乎占全球新生儿死亡负担的三分之一，而呼吸窘迫综合征仍然是这些可预防死亡的最常见单一原因。自近半个世纪前问世以来，经鼻持续气道正压通气（NCPAP）已发展成为发达国家和发展中国家新生儿呼吸护理的主要方式。尽管有证据表明低成本的气泡式NCPAP在降低新生儿死亡率方面有效，但其在资源有限的环境中尚未得到广泛应用。此外，发展中国家的许多三级医院仍在使用一种廉价的本地组装的气泡式NCPAP系统，其疗效和安全性未知。本综述简要概述了气泡式NCPAP的历史、生理益处、适应症、禁忌症和并发症。还总结了关于低成本气泡式NCPAP在新生儿重症监护病房有效性的证据。本文进一步详细介绍了在资源有限的环境中使用的本地组装气泡式NCPAP系统，并强调了接受气泡式NCPAP治疗的新生儿的护理方案、失败标准和撤机策略。
