Respiratory distress syndrome (RDS), a condition resulting from a lack of surfactant and underdeveloped lungs, affects the majority of babies born before 32 weeks of gestational age and is almost always fatal without effective treatment. A lifesaving procedure commonly used to treat RDS is continuous positive airway pressure (CPAP). Commercially available CPAP devices or ventilators are often unaffordable in resource-limited hospitals and clinics, and to compound the problem, unreliable power limits the practicality of this equipment in many of these settings. To address these challenges, health care workers often devise improvised solutions such as nasal bubble CPAP (bCPAP) kits—assembled using tubing, nasal prongs, and a water bottle as a bubbler. These improvised kits provide low-cost lifesaving respiratory support without the requirement for power or dedicated equipment. However, they rely on a 100 percent source of oxygen and lack the ability to blend air into the gas provided to the newborn. Excessive oxygen is extremely dangerous to preterm newborns, frequently resulting in complications such as retinopathy of prematurity (ROP), chronic lung disease (CLD), and brain damage.
Inspired by these improvised bCPAP kits, PATH, in collaboration with neonatologists and respiratory therapists at Seattle Children’s Hospital, developed a low cost bCPAP kit that includes two oxygen blenders capable of providing fixed 37 percent and 60 percent blends of oxygen. This low-cost bCPAP kit does not require assembly at the point of care and is designed to provide bCPAP therapy to preterm newborns with RDS without the requirement of a power source (i.e., electricity or battery) or a source of compressed medical air. Above: PATH’s bCPAP kit configuration. Below: PATH’s bCPAP kit. Photos: PATH. These oxygen blenders work by entraining room air into the flowing oxygen stream to provide a safer blend of gas for newborns to breathe when receiving bCPAP therapy. Designed to be inexpensive, robust and easy to use, the blenders provide a stable and reliable source of blended gas under all clinically relevant conditions of pressure and flow. This blended gas is much safer for preterm newborns than the 100 percent oxygen commonly given with improvised bCPAP kits, which reduces the risk of ROP, CLD, and brain damage.
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