SynthesisJournal of perinatology : official journal of the California Perinatal Association2016
Efficacy and safety of CPAP in low- and middle-income countries.
Synthesis in Journal of perinatology : official journal of the California Perinatal Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Continuous Positive Airway Pressure (CPAP) for severe pneumonia in low- and middle-income countries: A systematic review of contextual factors.Journal of global health · 2022Pooled it
- Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis.BMJ global health · 2021Pooled it
- Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review.Journal of global health · 2021Pooled it
- Acceptability of immediate CPAP for preterm infants in the delivery room to mothers, caregivers and healthcare workers in a low-resource setting: a qualitative study.BMC pediatrics · 2025Trial
- Non-invasive high-frequency oscillatory ventilation versus non-invasive intermittent mandatory ventilation as a rescue mode in preterm infants with respiratory distress on nasal CPAP-a randomized control trial.European journal of pediatrics · 2025Trial
- RAM cannula versus short binasal prongs for nasal continuous positive airway pressure delivery in preterm infants: a randomized, noninferiority trial from low-middle-income country.European journal of pediatrics · 2022Trial
- Bubble continuous positive airway pressure for children with high-risk conditions and severe pneumonia in Malawi: an open label, randomised, controlled trial.The Lancet. Respiratory medicine · 2019Trial
- Nasal masks or binasal prongs for delivering continuous positive airway pressure in preterm neonates-a randomised trial.European journal of pediatrics · 2017Trial
- Article
- Comparison of methods of Weaning from Nasal Continuous Positive Airway Pressure in Preterm Infants: A Randomized Controlled Trial.Pakistan journal of medical sciences · 2026Article
- Respiratory support during neonatal and infant aeromedical interfacility transfers in the Western Cape, South Africa: a retrospective review.BMC emergency medicine · 2025Article
- Design and Bench Testing of a Novel, Pediatric, Non-Invasive, Bubble Bilevel Positive Pressure Ventilation Device.Bioengineering (Basel, Switzerland) · 2025Article
- Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative.African journal of primary health care & family medicine · 2025Article
- Article
- Using a simplified Downes score to predict the receipt of surfactant in a highly resourced setting.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Increasing continuous positive airway pressure use rates in the delivery room for very preterm infants: a quality improvement initiative.Frontiers in pediatrics · 2025Article
- Evaluating the Feasibility of a Nonelectric Bubble CPAP System in the NICU of a Philippine Regional Referral Hospital: A Qualitative Study.International journal of pediatrics · 2025Article
- Bubble CPAP Therapy in Newborns With Respiratory Distress With Its Outcome-A Prospective Observational Study From a Neonatal Intensive Care Unit of Tertiary Care Hospital in Western Nepal.International journal of pediatrics · 2025Article
- Survive and Thrive: Outcomes of Children Enrolled in a Follow-Up Clinic for Small and Sick Newborns in Rural Rwanda.Healthcare (Basel, Switzerland) · 2024Article
- Impact of early continuous positive airway pressure in the delivery room (DR-CPAP) on neonates < 1500 g in a low-resource setting: a protocol for a pilot feasibility and acceptability randomized controlled trial.Pilot and feasibility studies · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We conducted a systematic review to evaluate the (1) feasibility and efficacy and (2) safety and cost effectiveness of continuous positive airway pressure (CPAP) therapy in low- and middle-income countries (LMIC). We searched the following electronic bibliographic databases-MEDLINE, Cochrane CENTRAL, CINAHL, EMBASE and WHOLIS-up to December 2014 and included all studies that enrolled neonates requiring CPAP therapy for any indication. We did not find any randomized trials from LMICs that have evaluated the efficacy of CPAP therapy. Pooled analysis of four observational studies showed 66% reduction in in-hospital mortality following CPAP in preterm neonates (odds ratio 0.34, 95% confidence interval (CI) 0.14 to 0.82). One study reported 50% reduction in the need for mechanical ventilation following the introduction of bubble CPAP (relative risk 0.5, 95% CI 0.37 to 0.66). The proportion of neonates who failed CPAP and required mechanical ventilation varied from 20 to 40% (eight studies). The incidence of air leaks varied from 0 to 7.2% (nine studies). One study reported a significant reduction in the cost of surfactant usage with the introduction of CPAP. Available evidence suggests that CPAP is a safe and effective mode of therapy in preterm neonates with respiratory distress in LMICs. It reduces the in-hospital mortality and the need for ventilation thereby minimizing the need for up-transfer to a referral hospital. But given the overall paucity of studies and the low quality evidence underscores the need for large high-quality studies on the safety, efficacy and cost effectiveness of CPAP therapy in these settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.