Qin Fanghua, Dong Cuilan, Qiu Jun, Song Qingqing, Konomanyi Kumba, Sesay Lucinda Sia Fatmata, Xiao Aiqing
Department of NICU, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, Hunan, China.
Pediatrics Research Institute of Hunan Province, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, Hunan, China.
Front Pediatr. 2025 Apr 24;13:1534550. doi: 10.3389/fped.2025.1534550. eCollection 2025.
Continuous Positive Airway Pressure (CPAP) is an effective intervention for managing neonatal respiratory distress. However, its implementation encounters numerous challenges in resource-limited settings. It is imperative for healthcare professionals to devise highly practical and cost-effective modifications to CPAP systems to address these challenges.
To evaluate the clinical efficacy and operational feasibility of a modified bubble CPAP therapy utilizing locally available materials in reducing respiratory distress and improving survival rates of neonates in the Special Care Baby Unit (SCBU) of the Sierra Leone-China Friendship Hospital.
93 neonates with respiratory distress were divided into the control group ( = 48) for nasal cannula oxygen therapy and the observation group ( = 45) for modified bubble CPAP therapy. The modified CPAP device was constructed using locally available materials, such as drinking cups and modified nasal cannulas, with oxygen delivered via concentrators. Respiratory Severity Score, blood oxygen saturation, heart rate, and respiration were monitored with data recorded at admission and 8 h after intervention.
After intervention, the neonates in the observation group showed significant improvements in all parameters: decreased RSS scores (7.40 ± 0.986 vs. 5.33 ± 1.447, < 0.001), heart rate (153.13 ± 5.998 vs. 141.60 ± 8.830, < 0.001), and respiratory rate (47.87 ± 4.103 vs. 43.47 ± 3.833, < 0.01), and higher oxygen saturation (73.60% ± 10.636% vs. 91.07% ± 8.940%, < 0.001) and survival rate (88% vs. 62.5%, < 0.01).
The study indicated that the implementation of modified bubble CPAP therapy enhanced respiratory outcomes and increased survival rates among neonates experiencing respiratory distress in a resource-constrained setting in rural Sierra Leone.
持续气道正压通气(CPAP)是治疗新生儿呼吸窘迫的有效干预措施。然而,在资源有限的环境中实施该措施面临诸多挑战。医疗保健专业人员必须对CPAP系统进行高度实用且具有成本效益的改进,以应对这些挑战。
评估在塞拉利昂-中国友谊医院特别护理婴儿病房(SCBU)中,使用当地可得材料的改良气泡式CPAP疗法在减轻新生儿呼吸窘迫和提高存活率方面的临床疗效及操作可行性。
将93例呼吸窘迫新生儿分为对照组(n = 48),采用鼻导管给氧疗法;观察组(n = 45),采用改良气泡式CPAP疗法。改良CPAP装置使用当地可得材料制成,如饮水杯和改良鼻导管,通过氧气浓缩器输送氧气。监测呼吸严重程度评分、血氧饱和度、心率和呼吸情况,并记录入院时及干预8小时后的相关数据。
干预后,观察组新生儿在所有参数上均有显著改善:呼吸严重程度评分降低(7.40 ± 0.986对5.33 ± 1.447,P < 0.001)、心率降低(153.13 ± 5.998对141.60 ± 8.830,P < 0.001)、呼吸频率降低(47.87 ± 4.103对43.47 ± 3.833,P < 0.01),血氧饱和度升高(73.60% ± 10.636%对91.07% ± 8.940%,P < 0.001),存活率提高(88%对62.5%,P < 0.01)。
该研究表明,在塞拉利昂农村资源有限的环境中,实施改良气泡式CPAP疗法可改善呼吸窘迫新生儿的呼吸结局并提高存活率。