Critical Breaths in Transit: A Review of Non-invasive Ventilation (NIV) for Neonatal and Pediatric Patients During Transportation

Abstract

Respiratory illnesses are a leading cause of death for children worldwide, with the majority of these cases occurring from preterm birth complications or acute respiratory infections. Appropriate respiratory intervention must be provided quickly to lower the chances of death or permanent harm. As a result, respiratory support given in prehospital and interfacility transport can substantially improve health outcomes for these patients, particularly in areas where transportation time to appropriate facilities is lengthy. Existing literature supports the use of non-invasive ventilation (NIV), such as nasal or bilevel continuous positive airway pressure, as a safe form of respiratory support for children under 18 years old in certain transportation settings. This mini review summarizes the literature on pediatric NIV in transport and highlights significant gaps that future researchers should address. In particular, we identify the need to: solidify clinical guidelines for the selection of eligible pediatric patients for transport on NIV; explore the range of factors influencing successful NIV implementation during transportation; and apply appropriate best practices in low and middle income countries.

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

“…Easy device operation, low resource utilization, and low maintenance requirements were critical factors for integration [12,13,19]. Future research should study feasibility of use of Vayu bCPAP Systems in lower level facilities and transport settings, and identify attributes that optimize outcomes [4].…”

“…The World Health Organization (WHO) has declared reduction of neonatal deaths a global priority [1]. Two and a half million infants annually succumb to complications from preterm birth during the first month of life, primarily in low-resource settings [2][3][4][5][6][7]. Acute respiratory distress caused by conditions such as Respiratory Distress Syndrome (RDS), pneumonia, meconium aspiration, sepsis, and birth asphyxia is the leading cause of morbidity and mortality during the neonatal period [8,9].…”

Feasibility of a Novel Ultra-Low-Cost Bubble CPAP (bCPAP) System for Neonatal Respiratory Support at Muhimbili National Hospital, Tanzania

“…(8,14,15) Future research should study feasibility of use of Vayu bCPAP Systems in lower level facilities and transport settings, and identify attributes that optimize outcomes. (30)…”

Possibility of using non-invasive modes of respiratory support at the stages of interhospital transportation of newborns

“…подтверждает, что неинвазивная респираторная поддержка для новорожденных и детей безопасна при транспортировке и может улучшить результаты лечения пациентов. Однако необходимы дополнительные исследования для разработки протоколов отбора пациентов и обоснования применяемых параметров и условий [38]. D. Trevisanuto с соавт., выполняя анализ 3 337 случаев проведения интенсивной терапии новорожденным в исходных медицинских организациях 1 и 2 уровней с 2000 по 2019 гг.…”

“…D. Trevisanuto с соавт., выполняя анализ 3 337 случаев проведения интенсивной терапии новорожденным в исходных медицинских организациях 1 и 2 уровней с 2000 по 2019 гг. (гестационный возраст − 36 (32)(33)(34)(35)(36)(37)(38)(39), масса при рождении 2 570 г (1760-3246)) констатиро-вали, что использование назального постоянного положительного давления в дыхательных путях (9,72 %) и назальной высокопоточной канюли (58,51 %) в исходных медицинских организациях, а также случаев применения nCPAP (13,87 %) и nIPPV (32,46 %) во время транспортировки увеличилось. При этом доля пациентов на ИВЛ снизилась (10,77 %) [39].…”