Use of Nasal Bubble CPAP in Children with Hypoxemic Clinical Pneumonia—Report from a Resource Limited Set-Up

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Abstract

Objective: Nasal bubble continuous positive airway pressure (bCPAP) is preferred in developing economies for easy applicability and low cost. Because its use in older children is unexplored, we sought to evaluate its utility in hypoxemic clinical pneumonia.

Methods: Of 330 children (1 month–12 years) with clinical pneumonia enrolled prospectively over 1 year, those with increased work of breathing and/or SpO 2 <92% received bCPAP delivered via an underwater ‘T' tube through nasal prongs. Proportion requiring intubation despite bCPAP constituted primary outcome. Incidence of complications, duration of bCPAP and emergency stay were secondary outcomes.

Results: Oxygen was initiated by nasal prongs (NPO 2 ) in 204 (61.8%), and by bCPAP in 110 (33.3%). Sixteen (4.8%) were intubated at the outset. Fifty-three (25.9%) on NPO 2 were shifted to bCPAP for worsening distress and hypoxemia. Only three (1.8%) from bCPAP group required intubation, of which one died. Failure rate and complications were negligent. The median emergency stay was 4 days.

Conclusions: Nasal bCPAP was safe and effective in children with hypoxemic clinical pneumonia.

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