title: Outcomes of Patients with Respiratory Distress Treated with Bubble CPAP on a Pediatric Ward in Malawi.
abstract: OBJECTIVE
  To describe the outcomes of infants and young children with respiratory distress when treated with a novel, low-cost, stand-alone bubble Continuous Positive Airway Pressure (bCPAP) system in a resource-limited setting.
  
  
  METHODS
  A non-randomized, convenience sample study in a pediatric unit in Blantyre, Malawi, 2013. Patients weighing ≤10 kg with respiratory distress were eligible. We compared outcomes for patients with bronchiolitis, pneumonia and Pneumocystis jiroveci pneumonia (PJP) after treatment with bCPAP.
  
  
  RESULTS
  Seventy percent of patients treated with bCPAP survived. Outcomes were best for patients with bronchiolitis and worst for those with PJP. Most survivors (80%) showed improvement within 24 h. All treating physicians found bCPAP useful, leading to a change in practice.
  
  
  CONCLUSIONS
  Bubble CPAP was most beneficial to patients with bronchiolitis. Children, who were going to get well, tended to get well quickly. Physicians believed the bCPAP system provided a higher level of care than nasal oxygen.
authors.affiliation: Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA hemachen@texaschildrens.org.
authors.forename: Heather E
authors.initials: HE
authors.lastname: Machen
authors.affiliation: Paediatric Department, College of Medicine, Blantyre 3, Malawi.
authors.forename: Zondiwe V
authors.initials: ZV
authors.lastname: Mwanza
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX, USA.
authors.forename: Jocelyn K
authors.initials: JK
authors.lastname: Brown
authors.affiliation: Paediatric Department, College of Medicine, Blantyre 3, Malawi.
authors.forename: Kondwani M
authors.initials: KM
authors.lastname: Kawaza
authors.affiliation: Paediatric Department, College of Medicine, Blantyre 3, Malawi.
authors.forename: Laura
authors.initials: L
authors.lastname: Newberry
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX, USA.
authors.forename: Rebecca R
authors.initials: RR
authors.lastname: Richards-Kortum
authors.affiliation: Department of Bioengineering, Rice University, Houston, TX, USA.
authors.forename: Z Maria
authors.initials: ZM
authors.lastname: Oden
authors.affiliation: Paediatric Department, College of Medicine, Blantyre 3, Malawi.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Molyneux
mesh_terms: D001988:Bronchiolitis / Q000473:pathology / Q000628:therapy*; D045422:Continuous Positive Airway Pressure / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008295:Malawi / Q000453:epidemiology; D008297:Male; D010102:Oxygen Inhalation Therapy; D045363:Pneumocystis carinii; D011014:Pneumonia / Q000473:pathology / Q000628:therapy*; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: bubble CPAP; low cost device; pediatric; resource limited setting; respiratory distress