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|Title: ||A Randomized Clinical Trial Evaluating Nasal Continuous Positive Airway Pressure for Acute Respiratory Distress in a Developing Country|
|Authors: ||Moresky, Rachel T.|
Biagas, Katherine V.
Morris, Marilyn C.
Wilson, Patrick T.
Continuous positive airway pressure
Arterial oxygen saturation
|Issue Date: ||May-2013|
|Publisher: ||The Journal of Pediatrics|
|Citation: ||The Journal of Pediatrics Volume 162, Issue 5, May 2013, Pages 988–992|
|Abstract: ||Objective Invasive mechanical ventilation is often not an option for children with acute respiratory infections in
developing countries. An alternative is continuous positive airway pressure (CPAP). The authors evaluated the
effectiveness of CPAP in children presenting with acute respiratory distress in a developing country.
Study design A randomized, controlled trial was conducted in 4 rural hospitals in Ghana. Children, 3 months to
5 years of age, presenting with tachypnea and intercostal or subcostal retractions or nasal flaring were randomly
assigned to receive CPAP immediately or 1 hour after presentation. CPAP was applied by locally trained nurses.
The primary outcome measure was change in respiratory rate at 1 hour.
Results The study was stopped after the enrollment of 70 subjects because of a predetermined stop value of
P < .001. Mean respiratory rate of children who received immediate CPAP fell by 16 breaths/min (95% CI 10-21)
in the first hour compared with no change in children who had CPAP delayed by 1 hour (95% CI 2 to +5).
Thirty-five of the patients had a positive malaria blood smear. There were 3 deaths as a result of severe malaria.
No major complications of CPAP use were noted.
Conclusions CPAP decreases respiratory rate in children with respiratory distress compared with children not
receiving CPAP. The technology was successfully used by local nurses. No complications were associated with
its use. CPAP is a relatively low-cost, low-technology that is a safe method to decrease respiratory rate in children
with nonspecific respiratory distress.|
|Description: ||This Article was published by The Journal of Pediatrics
Volume 162, Issue 5, May 2013, Pages 988–992|
|Appears in Collections:||College of Health Sciences|
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