ArticleBMJ open2020
Availability and use of continuous positive airway pressure (CPAP) for neonatal care in public health facilities in India: a cross-sectional cluster survey.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Ram cannula vs nasal mask interface for providing CPAP in preterm neonates (< 34 weeks) with respiratory distress syndrome in a low- and middle-income country: an open-label, non-inferiority randomized controlled trial.European journal of pediatrics · 2026Trial
- Feasibility of integration of a novel bCPAP system into the NICU of a Public Referral Hospital in Mysuru, India.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Neonatal unit human resources: coverage for six cadres and trends for staff-to-baby ratios in 65 neonatal units implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania.Human resources for health · 2025Article
- Availability and functioning of neonatal care units and neonatal mortality across five regions in Tanzania: a baseline cross-sectional study in 127 CEmONC health facilities.BMJ global health · 2025Article
- A survey on the use of continuous positive airway pressure in newborn care in Kenya in 2017-2018.PloS one · 2025Article
- Management of neonates with respiratory distress syndrome in resource-limited settings.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- Effects of continuous nursing on rehabilitation compliance, living quality and daily living ability of patients with acute ischemic stroke.American journal of translational research · 2022Article
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Authors and funding
6 authors.
Funding
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Abstract
objectivesTo determine the availability of continuous positive airway pressure (CPAP) and to provide an overview of its use in neonatal units in government hospitals across India.
settingCross-sectional cluster survey of a nationally representative sample of government hospitals from across India. PRIMARY OUTCOMES: Availability of CPAP in neonatal units. SECONDARY OUTCOMES: Proportion of hospitals where infrastructure and processes to provide CPAP are available. Case fatality rates and complication rates of neonates treated with CPAP.
resultsAmong 661 of 694 government hospitals with neonatal units that provided information on availability of CPAP for neonatal care, 68.3% of medical college hospitals (MCH) and 36.6% of district hospitals (DH) used CPAP in neonates. Assessment of a representative sample of 142 hospitals (79 MCH and 63 DH) showed that air-oxygen blenders were available in 50.7% (95% CI 41.4% to 60.9%) and staff trained in the use of CPAP were present in 56.0% (45.8% to 65.8%) of hospitals. The nurse to patient ratio was 7.3 (6.4 to 8.5) in MCH and 6.6 (5.5 to 8.3) in DH. Clinical guidelines were available in 31.0% of hospitals (22.2% to 41.4%). Upper oxygen saturation limits of above 94% were used in 72% (59.8% to 81.6%) of MCH and 59.3% (44.6% to 72.5%) of DH. Respiratory circuits were reused in 53.8% (42.3% to 63.9%) of hospitals. Case fatality rate for neonates treated with CPAP was 21.4% (16.6% to 26.2%); complication rates were 0.7% (0.2% to 1.2%) for pneumothorax, 7.4% (0.9% to 13.9%) for retinopathy and 1.4% (0.7% to 2.1%) for bronchopulmonary dysplasia.
conclusionsCPAP is used in neonatal units across government hospitals in India. Neonates may be overexposed to oxygen as the means to detect and treat consequences of oxygen toxicity are insufficient. Neonates may also be exposed to nosocomial infections by reuse of disposables. Case fatality rates for neonates receiving CPAP are high. Complications might be under-reported. Support to infrastructure, training, guidelines implementation and staffing are needed to improve CPAP use.
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