Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit.
<h4>Background</h4>Preterm birth and resulting respiratory failure is a leading cause of newborn death- the majority of which occur in resource-constrained settings and could be prevented with bubble continuous positive airway pressure (bCPAP). Commercialized devices are expensive, howev...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001354 |
| _version_ | 1797695618212167680 |
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| author | Anna B Hedstrom James Nyonyintono Eugene A Saxon Heidi Nakamura Hilda Namakula Beatrice Niyonshaba Josephine Nakakande Noelle Simpson Madeline Vaughan Alec Wollen Paul Mubiri Peter Waiswa Patricia S Coffey Maneesh Batra |
| author_facet | Anna B Hedstrom James Nyonyintono Eugene A Saxon Heidi Nakamura Hilda Namakula Beatrice Niyonshaba Josephine Nakakande Noelle Simpson Madeline Vaughan Alec Wollen Paul Mubiri Peter Waiswa Patricia S Coffey Maneesh Batra |
| author_sort | Anna B Hedstrom |
| collection | DOAJ |
| description | <h4>Background</h4>Preterm birth and resulting respiratory failure is a leading cause of newborn death- the majority of which occur in resource-constrained settings and could be prevented with bubble continuous positive airway pressure (bCPAP). Commercialized devices are expensive, however, and sites commonly use improvised devices utilizing 100% oxygen which can cause blindness. To address this, PATH and a multidisciplinary team developed a very low-cost bCPAP device including fixed-ratio oxygen blenders.<h4>Objective</h4>We assessed feasibility of use of the device on neonatal patients as well as the usability and acceptability of the device by healthcare workers. This study did not evaluate device effectiveness.<h4>Methods</h4>The study took place in a Ugandan level two unit. Neonates with respiratory failure were treated with the bCPAP device. Prospective data were collected through observation as well as likert-style scales and interviews with healthcare workers. Data were analyzed using frequencies, means and standard deviation and interviews via a descriptive coding method. Retrospectively registered via ClinicalTrials.gov number NCT05462509.<h4>Results</h4>Fourteen neonates were treated with the bCPAP device in October-December 2021. Patients were born onsite (57%), with median weight of 1.3 kg (IQR 1-1.8). Median treatment length was 2.5 days (IQR 2-6). bCPAP was stopped due to: improvement (83%) and death (17%). All patients experienced episodes of saturations >95%. Median time for device set up: 15 minutes (IQR 12-18) and changing the blender: 15 seconds (IQR 12-27). After initial device use, 9 out of 9 nurses report the set-up as well as blender use was "easy" and their overall satisfaction with the device was 8.5/10 (IQR 6.5-9.5). Interview themes included the appreciation for the ability to administer less than 100% oxygen, desire to continue use of the device, and a desire for additional blenders.<h4>Conclusions</h4>In facilities otherwise using 100% oxygen, use of the bCPAP device including oxygen blenders is feasible and acceptable to healthcare workers.<h4>Trial registration</h4>ClinicalTrials.gov, Identifier NCT05462509. |
| first_indexed | 2024-03-12T03:14:52Z |
| format | Article |
| id | doaj.art-2d55186af3b540adabc202645a17a774 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T03:14:52Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-2d55186af3b540adabc202645a17a7742023-09-03T14:12:37ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0133e000135410.1371/journal.pgph.0001354Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit.Anna B HedstromJames NyonyintonoEugene A SaxonHeidi NakamuraHilda NamakulaBeatrice NiyonshabaJosephine NakakandeNoelle SimpsonMadeline VaughanAlec WollenPaul MubiriPeter WaiswaPatricia S CoffeyManeesh Batra<h4>Background</h4>Preterm birth and resulting respiratory failure is a leading cause of newborn death- the majority of which occur in resource-constrained settings and could be prevented with bubble continuous positive airway pressure (bCPAP). Commercialized devices are expensive, however, and sites commonly use improvised devices utilizing 100% oxygen which can cause blindness. To address this, PATH and a multidisciplinary team developed a very low-cost bCPAP device including fixed-ratio oxygen blenders.<h4>Objective</h4>We assessed feasibility of use of the device on neonatal patients as well as the usability and acceptability of the device by healthcare workers. This study did not evaluate device effectiveness.<h4>Methods</h4>The study took place in a Ugandan level two unit. Neonates with respiratory failure were treated with the bCPAP device. Prospective data were collected through observation as well as likert-style scales and interviews with healthcare workers. Data were analyzed using frequencies, means and standard deviation and interviews via a descriptive coding method. Retrospectively registered via ClinicalTrials.gov number NCT05462509.<h4>Results</h4>Fourteen neonates were treated with the bCPAP device in October-December 2021. Patients were born onsite (57%), with median weight of 1.3 kg (IQR 1-1.8). Median treatment length was 2.5 days (IQR 2-6). bCPAP was stopped due to: improvement (83%) and death (17%). All patients experienced episodes of saturations >95%. Median time for device set up: 15 minutes (IQR 12-18) and changing the blender: 15 seconds (IQR 12-27). After initial device use, 9 out of 9 nurses report the set-up as well as blender use was "easy" and their overall satisfaction with the device was 8.5/10 (IQR 6.5-9.5). Interview themes included the appreciation for the ability to administer less than 100% oxygen, desire to continue use of the device, and a desire for additional blenders.<h4>Conclusions</h4>In facilities otherwise using 100% oxygen, use of the bCPAP device including oxygen blenders is feasible and acceptable to healthcare workers.<h4>Trial registration</h4>ClinicalTrials.gov, Identifier NCT05462509.https://doi.org/10.1371/journal.pgph.0001354 |
| spellingShingle | Anna B Hedstrom James Nyonyintono Eugene A Saxon Heidi Nakamura Hilda Namakula Beatrice Niyonshaba Josephine Nakakande Noelle Simpson Madeline Vaughan Alec Wollen Paul Mubiri Peter Waiswa Patricia S Coffey Maneesh Batra Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit. PLOS Global Public Health |
| title | Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit. |
| title_full | Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit. |
| title_fullStr | Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit. |
| title_full_unstemmed | Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit. |
| title_short | Feasibility and usability of a very low-cost bubble continuous positive airway pressure device including oxygen blenders in a Ugandan level two newborn unit. |
| title_sort | feasibility and usability of a very low cost bubble continuous positive airway pressure device including oxygen blenders in a ugandan level two newborn unit |
| url | https://doi.org/10.1371/journal.pgph.0001354 |
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