Evaluation of a Low-Cost Bubble CPAP System Designed for Resource-Limited Settings
Evaluation of a Low-Cost Bubble CPAP System Designed for Resource-Limited Settings
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DOI：
10.4187/respcare.05762
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发表时间：
2018-04-01
期刊：
影响因子：
2.5
通讯作者：
Kacmarek, Robert M.
中科院分区：
文献类型：
--
作者：
Bennett, Desmond J.;Carroll, Ryan W.;Kacmarek, Robert M.
背景：呼吸损害是全球新生儿死亡的主要原因。CPAP是一种治疗方法，有助于在呼气期间保持肺容量，促进舒适的呼吸，并改善氧合。气泡式CPAP是标准CPAP的有效替代方法。我们试图确定为低资源环境设计的低成本气泡CPAP设备的可靠性和功能性。方法：将低成本的气泡CPAP装置与市售的气泡CPAP系统进行比较。这些设备被连接到一个肺部模拟器，该模拟器模拟4个不同体重的新生儿的呼吸力学受损(类似于1，类似于3，类似于5，类似于10公斤)。比较了这两种装置在正常和泄漏条件下建立和维持压力和流量的能力。压力水平(5、8和10 cm H2O)和流量水平(3、6和10 L/分钟)的多种组合被测试。通过连续运行系统8h并测量压力和流量的变化来测试两种装置的耐久性。结果：在无渗漏和渗漏试验中，两种装置的性能相当。虽然我们的测试显示了在特定的CPAP和血流水平设置中具有统计学意义和临床重要性的个体差异(>；10%的差异)，但没有对CPAP或FLOW的总体比较具有统计学意义和临床重要性。每个设备提供的压力与期望的压力相似，尽管在大多数试验中，两台机器提供的流量都低于设定的流量。在耐力试验中，低成本的设备在维持压力方面略好一些，而商业上可用的设备在保持血流方面更好。结论：本研究中评估的低成本气泡CPAP装置与发达环境中使用的气泡CPAP系统相当。然而，需要进行广泛的临床试验来证实其有效性。(C)2018年代达罗斯企业
BACKGROUND: Respiratory compromise is a leading contributor to global neonatal death. CPAP is a method of treatment that helps maintain lung volume during expiration, promotes comfortable breathing, and improves oxygenation. Bubble CPAP is an effective alternative to standard CPAP. We sought to determine the reliability and functionality of a low-cost bubble CPAP device designed for low-resource settings. METHODS: The low-cost bubble CPAP device was compared to a commercially available bubble CPAP system. The devices were connected to a lung simulator that simulated neonates of 4 different weights with compromised respiratory mechanics (similar to 1, similar to 3, similar to 5, and similar to 10 kg). The devices' abilities to establish and maintain pressure and flow under normal conditions as well as under conditions of leak were compared. Multiple combinations of pressure levels (5, 8, and 10 cm H2O) and flow levels (3, 6, and 10 L/min) were tested. The endurance of both devices was also tested by running the systems continuously for 8 h and measuring the changes in pressure and flow. RESULTS: Both devices performed equivalently during the no-leak and leak trials. While our testing revealed individual differences that were statistically significant and clinically important (>10% difference) within specific CPAP and flow-level settings, no overall comparisons of CPAP or flow were both statistically significant and clinically important. Each device delivered pressures similar to the desired pressures, although the flows delivered by both machines were lower than the set flows in most trials. During the endurance trials, the low-cost device was marginally better at maintaining pressure, while the commercially available device was better at maintaining flow. CONCLUSIONS: The low-cost bubble CPAP device evaluated in this study is comparable to a bubble CPAP system used in developed settings. Extensive clinical trials, however, are necessary to confirm its effectiveness. (c) 2018 Daedalus Enterprises