Feasibility of using continuous positive airway pressure

Background: Continuous positive airway pressure (CPAP) is a well-established treatment modality for children in moderate and severe respiratory failure in well-resourced settings. However, the availability of CPAP is generally poor in many resource-limited settings, in large part because existing CPAP devices are not designed for cost and resource efficiency, which precludes their use. The LeVe CPAP System has been co-developed by an international multidisciplinary team specifically for use in low-resource settings. In this paper we report the first study evaluating the efficacy of using the LeVe CPAP System as an intervention for children with acute hypoxaemic respiratory failure at Mengo Hospital in Kampala, Uganda. Methods: A total of 42 paediatric patients were recruited onto the study, all of whom were failing to maintain oxygen saturation above 88% at room conditions. Key clinical measures, including oxygen saturation, heart rate, respiratory rate and dyspnoea were recorded every hour for the length of admission on the paediatric ward. Results: At completion, 39 patients had recovered and were successfully discharged while 3 of 42 (7%) died in the early phases of treatment. Surviving patients showed improvements in all clinical measures, particularly in the first 12 h of treatment, and no adverse effects were reported after continued use. Additionally, we interviewed five parents whose children were undergoing treatment to gain a qualitative assessment of perceptions to the LeVe CPAP System. Conclusion: Outcomes of the study demonstrate the capability of the LeVe CPAP System to treat paediatric patients in respiratory failure and support the system's wider adoption in low-resource settings.