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Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system
INTRODUCTION: Access to inexpensive respiratory support to newborn infants improves survival in low-income countries. Standard bubble continuous positive airway pressure (CPAP) has been extensively used worldwide for more than 30 years. One project aimed at providing affordable CPAP is the Pumani sy...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5955547/ https://www.ncbi.nlm.nih.gov/pubmed/29768512 http://dx.doi.org/10.1371/journal.pone.0196683 |
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author | Falk, Markus Donaldsson, Snorri Drevhammar, Thomas |
author_facet | Falk, Markus Donaldsson, Snorri Drevhammar, Thomas |
author_sort | Falk, Markus |
collection | PubMed |
description | INTRODUCTION: Access to inexpensive respiratory support to newborn infants improves survival in low-income countries. Standard bubble continuous positive airway pressure (CPAP) has been extensively used worldwide for more than 30 years. One project aimed at providing affordable CPAP is the Pumani system developed by Rice 360°. Compared to standard bubble CPAP the system has an unconventional design. The aim was to compare the Pumani system with two traditional bubble CPAP systems, focusing on in-vitro performance and safety. METHODS: The Pumani system was compared to traditional bubble CPAP from Fisher & Paykel (Auckland, New Zealand) and Diamedica (Devon, United Kingdom). The systems were tested using static flow resistance and simulated breathing for a range of fresh gas flows and submersion levels. RESULTS: There were large differences between the Pumani CPAP and the conventional bubble CPAP systems. The Pumani system was not pressure stable, had high resistance and high imposed work of breathing. It was not possible to use submersion depth to adjust CPAP without accounting for fresh gas flow. DISCUSSION: The Pumani design is novel and not similar to any previously described CPAP system. The main mechanism for CPAP generation was resistance, not submersion depth. The system should therefore not be referred to as bubble CPAP. The clinical consequences of its pressure instability and high imposed work of breathing are not known and trials on outcome and safety are needed. |
format | Online Article Text |
id | pubmed-5955547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-59555472018-05-25 Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system Falk, Markus Donaldsson, Snorri Drevhammar, Thomas PLoS One Research Article INTRODUCTION: Access to inexpensive respiratory support to newborn infants improves survival in low-income countries. Standard bubble continuous positive airway pressure (CPAP) has been extensively used worldwide for more than 30 years. One project aimed at providing affordable CPAP is the Pumani system developed by Rice 360°. Compared to standard bubble CPAP the system has an unconventional design. The aim was to compare the Pumani system with two traditional bubble CPAP systems, focusing on in-vitro performance and safety. METHODS: The Pumani system was compared to traditional bubble CPAP from Fisher & Paykel (Auckland, New Zealand) and Diamedica (Devon, United Kingdom). The systems were tested using static flow resistance and simulated breathing for a range of fresh gas flows and submersion levels. RESULTS: There were large differences between the Pumani CPAP and the conventional bubble CPAP systems. The Pumani system was not pressure stable, had high resistance and high imposed work of breathing. It was not possible to use submersion depth to adjust CPAP without accounting for fresh gas flow. DISCUSSION: The Pumani design is novel and not similar to any previously described CPAP system. The main mechanism for CPAP generation was resistance, not submersion depth. The system should therefore not be referred to as bubble CPAP. The clinical consequences of its pressure instability and high imposed work of breathing are not known and trials on outcome and safety are needed. Public Library of Science 2018-05-16 /pmc/articles/PMC5955547/ /pubmed/29768512 http://dx.doi.org/10.1371/journal.pone.0196683 Text en © 2018 Falk et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Falk, Markus Donaldsson, Snorri Drevhammar, Thomas Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system |
title | Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system |
title_full | Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system |
title_fullStr | Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system |
title_full_unstemmed | Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system |
title_short | Infant CPAP for low-income countries: An experimental comparison of standard bubble CPAP and the Pumani system |
title_sort | infant cpap for low-income countries: an experimental comparison of standard bubble cpap and the pumani system |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5955547/ https://www.ncbi.nlm.nih.gov/pubmed/29768512 http://dx.doi.org/10.1371/journal.pone.0196683 |
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