Improvised bubble continuous positive airway pressure ventilation use in neonates in resource-limited settings: a systematic review and meta-analysis

Fatima Usman; Zubaida L. Farouk; Fatimah I. Tsiga-Ahmed; Muhammed Abdussalam; Rabiu I. Jalo; Sa’adatu S. Mohammad; Muktar H. Aliyu

doi:10.1515/jpm-2022-0009

Article

Improvised bubble continuous positive airway pressure ventilation use in neonates in resource-limited settings: a systematic review and meta-analysis

Fatima Usman , Zubaida L. Farouk , Fatimah I. Tsiga-Ahmed , Muhammed Abdussalam , Rabiu I. Jalo , Sa’adatu S. Mohammad and Muktar H. Aliyu

Published/Copyright: March 10, 2022

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From the journal Journal of Perinatal Medicine Volume 51 Issue 7

Abstract

Objectives

In the face of limited fiscal and technical resources, improvised methods have been used to provide effective and sustainable ventilatory support in low-resource settings to reduce neonatal mortality associated with respiratory complications. This study assessed the use of improvised bubble continuous positive airway pressure (ibCPAP) ventilation among neonates with respiratory complications and determined its effect on neonatal outcomes in low- and middle-income countries (LMICs).

Content

Hospital-based studies conducted between 2010 and 2020 in LMICs were reviewed. Rayyan^® software for systematic review was used for screening and article selection. We used Stata^® Statacorp Texas USA software to estimate pooled prevalence, proportion estimates, weighted mean differences and 95% Confidence Interval (CI), using the random effects model.

Summary

A total of 193 articles were generated and 125 were reviewed. Thirteen articles with 806 neonates on ibCPAP ventilation were included. The pooled prevalence of ibCPAP use was 7.0% (95% CI: 3.0%–13.0%). There was a significant difference in mean oxygen saturation before and after ibCPAP use (−1.34% [95% CI: −1.65% to −1.02%, p<0.01). The duration of oxygen requirement among neonates on ibCPAP was 6.5 hours less than controls (0.27 days [95%CI: −0.49 to −0.05, p<0.01).

Outlook

IbCPAP had no effect on the respiratory rate, duration of admission, mortality and survival. IbCPAP use in LMIC hospitals is low and its use improved oxygen saturation and duration on oxygen among the neonates, but had no impact on length of stay, respiratory rate, mortality or survival.

Keywords: ibCPAP; improvised bubble continuous positive airway pressure; LMICs, resource-limited countries; low-cost bubble continuous positive airway pressure; respiratory support

Corresponding author: Fatimah I. Tsiga-Ahmed, MBBS, MSc, FWACP, Department of Community Medicine, Bayero University, Kano & Aminu Kano Teaching Hospital, Kano, Nigeria, Phone: +234 8033148264, E-mail: fitsiga.cmed@buk.edu.ng

Research funding: No external funding was involved in the preparation of this manuscript.
Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Not applicable.
Ethical approval: Not applicable.

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Received: 2022-01-07

Revised: 2022-02-07

Accepted: 2022-02-14

Published Online: 2022-03-10

Published in Print: 2023-09-26

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Articles in the same Issue

https://doi.org/10.1515/jpm-2022-0009

Keywords for this article

ibCPAP; improvised bubble continuous positive airway pressure; LMICs, resource-limited countries; low-cost bubble continuous positive airway pressure; respiratory support