Low-Cost Modified Bubble Continuous Positive Airway Pressure for Stabilizing Neonates With Respiratory Distress Prior to Referral

Tioky Sutjonong, Bethseba Brontang Pulinggomang, Dominicus Husada

Abstract

The modified bubble continuous positive airway pressure (bCPAP) recommended by the World Health Organization is a simple and low-cost therapy recommended to improve oxygenation and reduce respiratory failure, which has the potential to lower morbidity and mortality in neonates.

In this article, we are sharing our experience of stabilizing a neonate with respiratory distress in a health care facility with limited resources, prior to referral, using a low-cost, modified bCPAP. A 1-hour-old male neonate with respiratory distress was brought to Lawahing Primary Healthcare Facility. The respiratory rate (RR) was 70 breaths/min, and preductal saturation was 88% of room oxygen. There was a mild subcostal retraction and groaning sound from both lungs. His extremities were cyanotic. He was diagnosed with moderate neonatal respiratory distress, and his Downes score was 4. The low-cost modified bCPAP was devised using the simple equipment available in the health care facility, and then it was used with a pressure of 7 cm H2O with an oxygen flow of 2 L/min. After applying bCPAP for 15 min, the RR had decreased to 50 breaths/min; preductal saturation had increased to 98%; and the subcostal retraction and peripheral cyanosis had reduced.

The low-cost modified bCPAP can be used in stabilizing neonates with respiratory distress in health care facilities with limited resources, prior to referral.