{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:14:19Z","timestamp":1787166859707,"version":"build-2736575974"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100007701","name":"American Society of Mechanical Engineers","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Infant respiratory distress is \u202fa significant cause of mortality globally. Bubble continuous positive airway pressure (CPAP) is a simple and effective therapy, but sicker infants may require additional support such as non-invasive positive-pressure ventilation (NIPPV). We investigated the feasibility of a simple, low-cost, non-electric bubble NIPPV device.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-over feasibility study, seven newborns with moderate respiratory distress (Downes score \u2265 3), weight &amp;gt; 1500\u2009g and gestational age &amp;gt; 32\u2009weeks were randomized to \u202f4\u2009h of treatment with bubble CPAP (5\u20138\u2009cm H2O) vs. bubble NIPPV (Phigh 8\u201310\u2009cm H2O\/Plow 5\u20138\u2009cm H2O) followed by 4\u2009h of the alternate treatment. Treatment order (CPAP vs. NIPPV) was randomized. Outcome measures included hourly vital signs, Downes score and O2 saturation. Adverse events including pneumothorax, nasal septal necrosis, necrotizing enterocolitis and death before discharge were also recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>It took nurses 39 (7.3) s to assemble the bubble NIPPV device. Patients had similar vital signs and Downes scores on both treatments; median (IQR) values on bubble CPAP vs. bubble NIPPV were: heart rate 140 (134.5, 144), 140 (134.5, 144); respiratory rate 70 (56, 80), 65 (58, 82), Downes score 4 (3, 5.75), 4 (3, 5), O2 96 (94, 98), 97 (96, 98). All newborns survived to discharge and there were no adverse events.\u202f<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simple, low-cost, non-electric method of providing NIPPV for newborns with respiratory distress is feasible in limited resource settings. Randomized-controlled trials comparing bubble CPAP and bubble NIPPV are justified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/tropej\/fmac095","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T15:12:58Z","timestamp":1666883578000},"source":"Crossref","is-referenced-by-count":5,"title":["Feasibility of bubble non-invasive positive pressure ventilation, a first-in-human study"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-4180","authenticated-orcid":false,"given":"Stephen C","family":"John","sequence":"first","affiliation":[{"name":"Department of Medicine Pediatrics, University of Minnesota , Minneapolis, MN 55455, USA"},{"name":"Biomedical Engineering, United Mission Hospital Tansen , Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikash Raj","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, United Mission Hospital Tansen , Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna V","family":"John","sequence":"additional","affiliation":[{"name":"Biomedical Engineering, United Mission Hospital Tansen , Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric O","family":"Cheng","sequence":"additional","affiliation":[{"name":"Respiratory Therapists Without Borders , Newmarket, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary M","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Neonatology, C. S. Mott Children\u2019s Hospital, Michigan Medicine , Ann Arbor, MI 48103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil P","family":"John","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, United Mission Hospital Tansen , Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,12]]},"reference":[{"key":"2022111219140643900_fmac095-B1","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/S0140-6736(05)71048-5","article-title":"Lancet neonatal survival steering team. 4 million neonatal deaths: when? Where? Why?","volume":"365","author":"Lawn","year":"2005","journal-title":"The Lancet"},{"key":"2022111219140643900_fmac095-B2","doi-asserted-by":"crossref","first-page":"F495","DOI":"10.1136\/archdischild-2013-305519","article-title":"Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review","volume":"99","author":"Martin","year":"2014","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2022111219140643900_fmac095-B3","first-page":"CD005384","article-title":"Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants","volume":"12","author":"Lemyre","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2022111219140643900_fmac095-B4","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1038\/jp.2009.165","article-title":"Nasal intermittent positive pressure ventilation in the newborn: review of literature and evidence-based guidelines","volume":"30","author":"Bhandari","year":"2010","journal-title":"J Perinatol"},{"key":"2022111219140643900_fmac095-B5","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.4187\/respcare.07346","article-title":"Bench testing of a bubble noninvasive ventilation device in an infant lung simulator","volume":"65","author":"John","year":"2020","journal-title":"Respir Care"},{"key":"2022111219140643900_fmac095-B6","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1038\/s41390-020-0928-0","article-title":"Bubble bilevel ventilation facilitates gas exchange in anesthetized rabbits","volume":"89","author":"John","year":"2020","journal-title":"Pediatr Res"},{"key":"2022111219140643900_fmac095-B7","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/000992287000900607","article-title":"Respiratory distress syndrome of newborn infants. I. New clinical scoring system (RDS score) with acid\u2013base and blood-gas correlations","volume":"9","author":"Downes","year":"1970","journal-title":"Clin Pediatr"},{"key":"2022111219140643900_fmac095-B8","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1159\/000013962","article-title":"A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in premature neonates ready for extubation","volume":"73","author":"Lee","year":"1998","journal-title":"Biol Neonate"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/68\/6\/fmac095\/47014171\/fmac095.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/68\/6\/fmac095\/47014171\/fmac095.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T14:14:14Z","timestamp":1668262454000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmac095\/6825446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":8,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,10,6]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmac095","relation":{},"ISSN":["1465-3664"],"issn-type":[{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,12,1]]},"published":{"date-parts":[[2022,10,6]]},"article-number":"fmac095"}}