title: Use of Nasal Bubble CPAP in Children with Hypoxemic Clinical Pneumonia-Report from a Resource Limited Set-Up.
abstract: OBJECTIVE
  Nasal bubble continuous positive airway pressure (bCPAP) is preferred in developing economies for easy applicability and low cost. Because its use in older children is unexplored, we sought to evaluate its utility in hypoxemic clinical pneumonia.
  
  
  METHODS
  Of 330 children (1 month-12 years) with clinical pneumonia enrolled prospectively over 1 year, those with increased work of breathing and/or SpO2 <92% received bCPAP delivered via an underwater 'T' tube through nasal prongs. Proportion requiring intubation despite bCPAP constituted primary outcome. Incidence of complications, duration of bCPAP and emergency stay were secondary outcomes.
  
  
  RESULTS
  Oxygen was initiated by nasal prongs (NPO2) in 204 (61.8%), and by bCPAP in 110 (33.3%). Sixteen (4.8%) were intubated at the outset. Fifty-three (25.9%) on NPO2 were shifted to bCPAP for worsening distress and hypoxemia. Only three (1.8%) from bCPAP group required intubation, of which one died. Failure rate and complications were negligent. The median emergency stay was 4 days.
  
  
  CONCLUSIONS
  Nasal bCPAP was safe and effective in children with hypoxemic clinical pneumonia.
authors.affiliation: Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India mjshree@hotmail.com mjshree64@gmail.com.
authors.forename: Muralidharan
authors.initials: M
authors.lastname: Jayashree
authors.affiliation: Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
authors.forename: H B
authors.initials: HB
authors.lastname: KiranBabu
authors.affiliation: Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
authors.forename: Sunit
authors.initials: S
authors.lastname: Singhi
authors.affiliation: Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
authors.forename: Karthi
authors.initials: K
authors.lastname: Nallasamy
mesh_terms: D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000382:microbiology / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011014:Pneumonia / Q000150:complications / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: clinical pneumonia; nasal bubble CPAP; respiratory distress Children