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VOLUME 27 , ISSUE 11 ( November, 2023 ) > List of Articles

PEDIATRIC CRITICAL CARE MEDICINE

Bubble Continuous Positive Airway Pressure Oxygen Therapy in Children Under Five Years of Age with Respiratory Distress in Pediatric Intensive Care Unit

AV Lalitha, Chandrakant G Pujari, John Michael Raj

Keywords : Continuous positive airway pressure, Pediatric intensive care unit, Pneumonia, Respiratory distress

Citation Information : Lalitha A, Pujari CG, Raj JM. Bubble Continuous Positive Airway Pressure Oxygen Therapy in Children Under Five Years of Age with Respiratory Distress in Pediatric Intensive Care Unit. Indian J Crit Care Med 2023; 27 (11):847-854.

DOI: 10.5005/jp-journals-10071-24563

License: CC BY-NC 4.0

Published Online: 30-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: Continuous positive airway pressure (CPAP) has been used in children with bronchiolitis for a long time. Currently in the low-resource settings, the method of providing oxygen therapy via bubble CPAP (bCPAP) to children with respiratory distress is not standardized and the existing low-flow oxygen therapy has a high mortality rate. Objectives: To study the effectiveness and safety of bCPAP as a respiratory support in children with respiratory distress. Materials and methods: This prospective observational study was conducted in a tertiary care pediatric intensive care unit (PICU) over a period of 3 months. Children with respiratory distress were administered with bCPAP oxygen therapy. Baseline demographic data, such as age, sex, weight, severity of illness was collected. Changes in heart rate, respiratory rate, saturation, respiratory distress score and failure rate after bCPAP therapy were studied. Results: During the study period, 30 children were recruited. Most common cause of respiratory distress requiring bCPAP was pneumonia (66.7%) followed by pleural effusion (20%) and bronchiolitis (13.3%). The median (IQR) CPAP duration and PICU stay in the study was 48 hours (27–48) and 4 days (4–8), respectively. Heart rate and respiratory rate, respiratory distress score improved significantly after CPAP therapy (p < 0.05). CPAP therapy failed in one child and required invasive ventilation. We did not observe any complications due to bCPAP therapy. Conclusion: The use of bCPAP in the treatment of respiratory distress is safe and effective.

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  1. Hasan MM, Saha KK, Yunus RM, Alam K. Prevalence of acute respiratory infections among children in India: Regional inequalities and risk factors. Matern Child Health J 2022;26(7):1594–1602. DOI: 10.1007/s10995-022-03424-3.
  2. McAllister DA, Liu L, Shi T, Chu Y, Reed C, Burrows J, et al. Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: A systematic analysis. Lancet Glob Health 2019;7:e47–e57. DOI: 10.1016/S2214-109X(18)30408-X.
  3. Subhi R, Adamson M, Campbell H, Weber M, Smith K, Duke T, et al. The prevalence of hypoxaemia among ill children in developing countries. Lancet Infect Dis 2009;9:219–227. DOI: 10.1016/S1473-3099(09)70071-4.
  4. Duke T, Frank D, Mgone J. Hypoxaemia in children with severe pneumonia in Papua New Guinea. Int J TB Lung Dis 2000;5:511–519. PMID: 11409576.
  5. Graham SM, English M, Hazir T, Enarson P, Duke T. Challenges to improving case management of childhood pneumonia at health facilities in resource-limited settings. Bull World Health Organ 2008; 86:349–355. DOI: 10.2471/BLT.07.048512.
  6. Ramachandran P, Nedunchelian K, Vengatesan A, Suresh S. Risk factors for mortality in community acquired pneumonia among children aged 1–59 months admitted in a referral hospital. Indian Pediatr 2012;49(11):889–895. DOI: 10.1007/s13312-012-0221-3.
  7. Jayashree M, Kiran Babu HB, Singhi S, Nallasamy K. Use of nasal bubble CPAP in children with hypoxemic clinical pneumonia-report from a resource limited set-up. J Trop Pediatr 2016;62(1):69–74. DOI: 10.1093/tropej/fmv063.
  8. Smith AG, Eckerle M, Mvalo T, Weir B, Martinson F, Calira A, et al. CPAP IMPACT: A protocol for a randomised trial of bubble continuous positive airway pressure versus standard care for high-risk children with severe pneumonia using adaptive design methods BMJ Open Resp Res 2017;4(1). DOI: 10.1136/bmjresp-2017-000195.
  9. Wood DW, Downes JJ, Lecks HI. A clinical scoring system for the diagnosis of respiratory failure. Preliminary report on childhood status asthmaticus. Am J Dis Child 1972;123(3):227–228. DOI: 10.1001/archpedi.1972.02110090097011.
  10. Koyamaibole L, Kado J, Qovu JD, Colquhoun S, Duke T. An evaluation of bubble-CPAP in a neonatal unit in a developing country: Effective respiratory support that can be applied by nurses. J Trop Pediatr 2006;52(4):249–253. DOI: 10.1093/tropej/fmi109.
  11. Lee KS, Dunn MS, Fenwick M, Shennan AT. A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in premature neonates ready for extubation. Biol Neonate 1998;73(2):69–75. DOI: 10.1159/000013962.
  12. Upadhyay A, Deorari AK. Continuous positive airway pressure – A gentler approach to ventilation. Indian Pediatr 2004;41(5):459–469. PMID: 15181296.
  13. Kaur C, Sema A, Beri RS, Puliyel JM. A simple circuit to deliver bubbling CPAP. Indian Pediatr 2008;45(4):312–314. PMID: 18451452.
  14. Cambonie G, Milési C, Jaber S, Amsallem F, Barbotte E, Picaud JC, et al. Nasal continuous positive airway pressure decreases respiratory muscles overload in young infants with severe acute viral bronchiolitis. Intensive Care Med 2008;34:1865–1872. DOI: 10.1007/s00134-008-1201-x.
  15. Vamvakiti E, Saha A, Linney M. 510 Use of nasal Cpap in infants with bronchiolitis in the South of England: A prospective, multicentre, observational study. Pediatric Research 2010;68(1):261–261. DOI: 10.1203/00006450-201011001-00510.
  16. Cesar RG, Bispo BRP, Felix PHCA, Modolo MCC, Souza AAF, Horigoshi NK, et al. High-flow nasal cannula versus continuous positive airway pressure in critical bronchiolitis: A randomized controlled pilot. J Pediatr Intensive Care 2020;9(4):248–255. DOI: 10.1055/s-0040-1709656.
  17. Pedersen MB, Vahlkvist S. Comparison of CPAP and HFNC in management of bronchiolitis in infants and young children. Children (Basel) 2017;4(4):28. DOI: 10.3390/children4040028.
  18. Metge P, Grimaldi C, Hassid S, Thomachot L, Loundou A, Martin C, et al. Comparison of a high flow humidified nasal cannula to nasal continuous positive airway pressure in children with acute bronchiolitis: Experience in a pediatric intensive care unit. Eur J Pediatr 2014;173:953–958. DOI: 10.1007/s00431-014-2275-9.
  19. Anitha GF, Velmurugan L, Sangareddi S, Nedunchelian K, Selvaraj V. Effectiveness of flow inflating device in providing continuous positive airway pressure for critically ill children in limited-resource settings: A prospective observational study. Indian J Crit Care Med 2016;20(8):441–447. DOI: 10.4103/0972-5229.188171.
  20. Pulsan F, Sobi K, Duke T. Continuous positive airway pressure in children with severe pneumonia and hypoxaemia in Papua New Guinea: An evaluation of implementation. Acta Paediatr 2019;108(10):1887–1895. DOI: 10.1111/apa.14796.
  21. Sarkar M, Sinha R, Roychowdhoury S, Mukhopadhyay S, Ghosh P, Dutta K, et al. Comparative study between noninvasive continuous positive airway pressure and hot humidified high-flow nasal cannulae as a mode of respiratory support in infants with acute bronchiolitis in pediatric intensive care unit of a tertiary care hospital. Indian J Crit Care Med 2018;22(2):85–90. DOI: 10.4103/ijccm.IJCCM_274_17.
  22. Chisti MJ, Salam MA, Smith JH, Ahmed T, Pietroni MA, Shahunja KM, et al. Bubble continuous positive airway pressure for children with severe pneumonia and hypoxaemia in Bangladesh: An open, randomised controlled trial. Lancet 2015;386(9998):1057–1065. DOI: 10.1016/S0140-6736(15)60249-5.
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