Bubble CPAP Boosts Neonatal Survival Rates

A new study describes a low-cost neonatal breathing system that increases the survival rate of newborns with severe respiratory illness.

Designed by bioengineering students at Rice University (Houston, TX, USA), the low-cost device, which costs about 15 times less than conventional bubble continuous positive airway pressure (CPAP) machines, offers a gentle and effective tool to manage babies in respiratory distress. The system consists of an adjustable flow generator and a pressure-regulated delivery system controlled by submerging a pressure control tube in a column of water; the mean pressure in the system is determined by the height of the water column. The pressurized air mix is delivered to the patient's nostrils via a set of binasal prongs.


The device was tested in a 10-month study of 87 pediatric patients at Queen Elizabeth Central Hospital (QECH; Blantyre, Malawi), with results showing that survival rates more than doubled for premature infants with respiratory distress syndrome (RDS), and more than tripled for babies with sepsis or very low birth weight (VLBW). Overall, the study demonstrated that the device increased the survival rate of newborns with severe respiratory illness from 44% to 71%.

Additional pilot programs for bubble CPAP are set to begin this year at teaching hospitals in Tanzania, Zambia, and South Africa. The researchers estimate that using the bubble CPAP device could possibly save the lives of 178,000 VLBW babies in Africa every year. The results of the study were published early online on January 23, 2014, in the open-access journal PLOS ONE.

“Premature birth is now the second leading cause of death among children worldwide, and most premature babies are born in low-resource settings where many of the basic technologies and approaches that lead to improved outcomes are unavailable,” said study coauthor QECH pediatrician Elizabeth Molyneux, MD. “The results from the bubble CPAP clinical study are dramatic, and thanks to the partnership of QECH, Rice, and the Malawi Ministry of Health, we are already implementing bubble CPAP nationwide.”

“It’s difficult to overstate the importance of the clinical results for bubble CPAP,” said study coauthor Professor of biomedical engineering Maria Oden, PhD, director of the Rice University Oshman Engineering Design Kitchen (OEDK). “Not only have we shown that this specific technology can save thousands of lives each year, we’ve also demonstrated a technology pipeline that can produce many similar technologies in the future.”

A stand-alone commercial bubble CPAP device can cost up to USD 6,000, too expensive for most developing world hospitals. The new, rugged bubble CPAP system can be made in small volume for a cost-of-goods of approximately USD 350, thanks to a simple design that uses available consumer-grade pumps, medical tubing, and regulators. It only requires the simple replacement of a cheap diaphragm approximately every two years for maintenance.

Related Links:
Rice University