Feasibility of a novel ultra-low-cost bubble CPAP (bCPAP) System for neonatal respiratory support at Muhimbili National Hospital, Tanzania

Abstract

Objective: Continuous Positive Airway Pressure (CPAP) is recommended in the treatment of respiratory distress syndrome of premature newborns, however there are significant barriers to its implementation in low-resource settings. The objective of this study was to evaluate the feasibility of use and integration of Vayu bCPAP Systems into the newborn unit at Muhimbili National Hospital in Tanzania.

Study design: A prospective qualitative study was conducted from April 6 to October 6 2021. Demographic and clinical characteristics of patients treated with Vayu bCPAP Systems were collected and analyzed. Healthcare workers were interviewed until thematic saturation. Interviews were transcribed, coded, and analyzed using a framework analysis.

Results: 370 patients were treated with Vayu bCPAP Systems during the study period. Mean birth weight was 1522 g (500-3800), mean duration of bCPAP treatment was 7.2 days (<1-39 d), and survival to wean was 81.4%. Twenty-four healthcare workers were interviewed and perceived Vayu bCPAP Systems as having become essential for treating neonatal respiratory distress at MNH. Key reasons were that Vayu bCPAP Systems improve patient outcomes, are easy to use, and more patients are now able to receive quality care. Barriers to integration included durability of oxygen tubing material and training.

Conclusions: It was feasible to implement and integrate Vayu bCPAP Systems into the care of neonates at Muhimbili National Hospital.

Fig 1

A: Vayu The bubble CPAP System is composed of (1) an external pressurized oxygen source (2) a Venturi blender (3) two bacterial viral filters, one on inspiratory and one on expiratory limb (4) humidifier (5) nasal prongs (6) pressure generator with an adjustable wand and (7) a warmer bracket. B: (1) hat; (2) two safety pins, (3) two rubber bands, (4) hook mustache, and (5) soft loop fasteners. C: Vayu blender.