An Innovative Air-Oxygen Blender for Continuous Positive Airway Pressure Support in Resource-Poor Locations: A Feasibility Study

Daga, by Subhashchandra; Joshi, Hemant; Gunjal, Prashant R.; Mhatre, Sameer

doi:10.1093/tropej/fmw085

Cited by 9 publications

(11 citation statements)

References 6 publications

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“…While, traditionally, oxygen blenders have been cost-prohibitive in resource-limited settings, recent technological advances in the creation of low-cost oxygen blenders may make them more widely available and published literature on their availability and use will likely be important going forward. 40 Additionally, there are no reports of the specific barriers faced by clinicians in appropriately initiating or ceasing neonatal oxygen therapy. Finally, and of significance, is the paucity of reports of systemwide assessments of availability and usage of pulse oximeters to monitor neonatal oxygen therapy and the multiple indications that facilities are currently giving oxygen without pulse oximeter monitoring.…”

Section: Discussionmentioning

confidence: 99%

Neonatal oxygen therapy in low- and middle-income countries: a pragmatic review

Zelasko

Omotayo

Berkelhamer

et al. 2020

Journal of Global Health Reports

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Background We assessed and summarized the peer-reviewed literature on the state of neonatal oxygen therapy in low and lower-middle income countries. Methods A literature search was performed in 3 online databases (Pub Med, EMBASE, CAB Global Health) and amongst USAID’s Service Provision Assessment (SPA) reports for publications pertaining to neonatal oxygen therapy in low and lower-middle income countries over the past 10 years (2007-2017). Results Our search yielded 474 records, of which 26 were relevant and included in the review. Maintenance and indirect costs associated with the procurement of oxygen may constitute barriers to oxygen supply. The quality of therapy provided to neonates was affected by factors including a lack of necessary equipment at neonatal healthcare facilities and high indirect costs associated with the procurement of oxygen. Pulse oximeters used for monitoring of oxygen therapy were available in healthcare facilities, but there is scant data on the frequency of that monitoring. There are some hospitals that deliver neonatal oxygen therapy without any necessary monitoring equipment. Prevalence of retinopathy of prematurity among neonates with risk factors ranged from 11.9-47.2%, which is notably higher than published rates in neonates of similar gestational age being treated in high-income countries. Conclusion There is a lack of data that provides direct estimates of availability of neonatal oxygen equipment and related clinical applications of oxygen therapy across health systems, particularly around the usage and availability of necessary monitoring equipment. Attention to the maintenance of oxygen and ancillary equipment for neonates and quality improvement initiatives to promote adherence to those guidelines can reduce the morbidity and mortality burden among neonates in low and lower-middle income countries.

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Section: Discussionmentioning

confidence: 99%

Neonatal oxygen therapy in low- and middle-income countries: a pragmatic review

Zelasko

Omotayo

Berkelhamer

et al. 2020

Journal of Global Health Reports

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“…CPAP was delivered by a "home-made", inexpensive (costing US $3), and easyto use version of CPAP delivery system. 4,5 For an average bed-occupancy of 13 babies, generally two staff nurses are on duty round-the-clock. One junior and one senior resident are present per shift of 8 hours.…”

Section: Methodsmentioning

confidence: 99%

Choosing wisely babies for retinopathy of prematurity screening is more important in low resource setting

2020

IJCEO

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Design: A prospective observational study. Setting: The study was conducted over a period of one year, from 01-07-2013 to 30-06-2014 at a hospital attached to a newly established rural medical college in India; located 45 km away from the regional eye centre. Subjects: All babies, without exclusions, were screened for retinopathy of prematurity (ROP) as per guidelines of National Neonatology Forum (NNF) of India, i.e. babies born < 34 weeks gestation and/or < 1750 g birth weight, and the babies 34-36 6/7 weeks gestation or 1750-2000 g birth weight, with risk factors for ROP. Interventions: 53 babies were screened for ROP as per NNF guidelines. Main Outcome Measures: 16 babies required laser therapy from the 53 babies that were screened over a period of one year. All weighed 1500 g or less at birth. Their GA was less than 33 weeks or less. Conclusion: BW 1500 g or less and/ or GA less than 34 weeks, appear to be appropriate ROP screening criteria. Applying NNF criteria, no ROP would have been missed. In 19 (35.8%) babies screening could have been avoided. It is desirable to determine appropriate ROP screening criteria for a particular centre; based on local evidence.

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“…27,32 Other types of oxygen blenders which make use of Y-connectors, Venturi nozzles, or air pumps are less expensive, but pilot studies have shown they have poor blending precision and often function over a very limited range of fraction of inspired oxygen. [33][34][35][36] These prototype devices do not yet have the performance characteristics required for widespread clinical deployment and are not likely to meet standards for regulatory approval.…”

Section: The Oxygen Blending Gapmentioning

confidence: 99%