National scale of neonatal CPAP to district hospitals in Malawi improves survival for neonates weighing between 1.0 and 1.3 kg
| Autor: | Rebecca Richards-Kortum, Aba Asibon, Elizabeth Molyneux, Kondwani Kawaza, Sara Liaghati-Mobarhan, Maria Oden, Alfred Chalira, Jennifer Carns, Norman Lufesi |
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| Rok vydání: | 2021 |
| Předmět: |
Malawi
Respiratory Distress Syndrome Newborn medicine.medical_specialty Pediatrics Respiratory illness Continuous Positive Airway Pressure business.industry medicine.medical_treatment Significant difference Infant Newborn Outcome measures Infant Hospitals District Oxygen Pediatrics Perinatology and Child Health medicine Humans Gestation Neonatology Continuous positive airway pressure business |
| Zdroj: | Archives of Disease in Childhood. 107:553-557 |
| ISSN: | 1468-2044 0003-9888 |
| Popis: | ObjectiveTo determine whether a national quality improvement programme implementing continuous positive airway pressure (CPAP) at government hospitals in Malawi improved outcomes for neonates prioritised by an algorithm recommending early CPAP for infants weighing 1.0–1.3 kg (the 50th percentile weight at 30 weeks’ gestation).DesignThe analysis includes neonates admitted with respiratory illness for 5.5 months before CPAP was introduced (baseline period) and for 15 months immediately after CPAP was implemented (implementation period). A follow-up data analysis was completed for neonates treated with CPAP for a further 11 months.Setting and patientsNeonates with admission weights of 1.0–1.3 kg before (106 neonates treated with nasal oxygen) and after implementation of CPAP (153 neonates treated with nasal oxygen, 103 neonates treated with CPAP) in the newborn wards at Malawi government district hospitals. Follow-up analysis included 87 neonates treated with CPAP.InterventionNeonatal CPAP.Main outcome measureWe assessed survival to discharge at 23 government district hospitals with no significant differences in transfer rates before and after implementation of CPAP.ResultsSurvival improved for neonates with admission weights from 1.0 to 1.3 kg treated with CPAP (30.1%) as compared with neonates of the same weight band treated with oxygen during the baseline (17.9%) and implementation (18.3%) periods. There was no significant difference in survival for neonates treated with CPAP during the implementation and follow-up periods (30.1% vs 28.7%).ConclusionsSurvival for neonates weighing 1.0–1.3 kg significantly increased with a nurse-led CPAP service in a low-resource setting and improvements were sustained during follow-up. |
| Databáze: | OpenAIRE |
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