Continuous positive airway pressure in children with severe pneumonia and hypoxaemia in Papua New Guinea: an implementation evaluation

by Pulsan F, Sobi K, Duke T

Published in Acta Paediatrica, 29 March 2019. 

 

 

The aim of this study was to prospectively evaluate the use of bubble continuous positive airway pressure (CPAP) in children with very severe pneumonia and other acute lower respiratory infections, during its trial introduction in a low resource hospital in Papua New Guinea.

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New guidelines for home oxygen therapy in children

by Susan Rahimi

Published in The Lancet Respiratory Medicine, 08 March 2019. DOI: https://doi.org/10.1016/S2213-2600(19)30076-1

 

 

"In February, 2019, the American Thoracic Society (ATS) released new guidance for home oxygen therapy in children with chronic respiratory conditions. These guidelines, drawn up by a panel of 22 experts in paediatric and neonatal medicine, respiratory therapy, and nursing and population health, as well as parents, aimed to define hypoxaemia in children and produce recommendations for supplementary home oxygen therapy in paediatric lung and pulmonary vascular diseases. Long-term oxygen therapy is increasingly used in both paediatric and adult patients. In June, 2007, 4% of all patients (3136 children) using long-term oxygen therapy in England and Wales were younger than 17 years. The most common diagnosis requiring long-term oxygen therapy is chronic neonatal lung disease. In these infants, peripheral capillary oxygen saturation (SpO2) of less than 90% is associated with an increased risk of apparent life-threatening events, whereas an SpO2 of 93% or higher is not. With increasing survival rates in premature babies, the need for long-term oxygen therapy has also increased and will continue to do so. Other conditions that require supplementary oxygen therapy are wide ranging and include pulmonary hypertension, intrapulmonary shunting, interstitial lung disease, and cystic fibrosis."   Access the full article here.   
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Performance of a novel reusable pediatric pulse oximeter probe

by King C, Mvalo T, Sessions K, Wilson I, Walker I, Zadutsa B, Makwenda C, Phiri T, Boyd N, Bernstein M, and McCollum ED

Published in Pediatric Pulmonology, 25 March 2019. 

 

 

The primary objective of this study was to assess the performance of reusable pulse oximeter probe and microprocessor box combinations, of varying price-points, in the context of a low-income pediatric setting. 

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Comparison of Biphasic vs Static Oxygen Saturation Targets Among Infants With Retinopathy of Prematurity

by Ankita Shukla, MD; Christine Sonnie, RN; Sarah Worley, MS; et al.

Published in JAMA Ophthalmology, 14 February 2019. 

 

 

The Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial (SUPPORT) demonstrated that static low oxygen saturation decreased retinopathy of prematurity (ROP) but increased mortality compared with static high oxygen saturation cohorts. The objective of this study was to compare outcomes of a biphasic oxygen protocol with static targets recommended by SUPPORT.

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Assessment of a storage system to deliver uninterrupted therapeutic oxygen during power outages in resource-limited settings

by R Calderon, MC Morgan, M Kuiper, H Nambuya, N Wangwe, A Somoskovi, and D Lieberman

Published in PLoS One, 06 February 2019. doi: 10.1371/journal.pone.0211027

 

 

Access to therapeutic oxygen remains a challenge in the effort to reduce pneumonia mortality among children in low- and middle-income countries. The use of oxygen concentrators is common, but their effectiveness in delivering uninterrupted oxygen is gated by reliability of the power grid. Often cylinders are employed to provide continuous coverage, but these can present other logistical challenges. In this study, researchers examined the use of a novel, low-pressure oxygen storage system to capture excess oxygen from a concentrator to be delivered to patients during an outage. A prototype was built and tested in a non-clinical trial in Jinja, Uganda. The trial was carried out at Jinja Regional Referral Hospital over a 75-day period. The flow rate of the unit was adjusted once per week between 0.5 and 5 liters per minute. Over the trial period, 1284 power failure episodes with a mean duration of 3.1 minutes (range 0.08 to 1720 minutes) were recorded. The low-pressure system was able to deliver oxygen over 56% of the 4,295 power outage minutes and cover over 99% of power outage events over the course of the study. These results demonstrate the technical feasibility of a method to extend oxygen availability and provide a basis for clinical trials.

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