{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:50:39Z","timestamp":1777891839497,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2014,11,11]],"date-time":"2014-11-11T00:00:00Z","timestamp":1415664000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Respiratory distress is a leading cause of neonatal death in low-income and middle-income countries. CPAP is a simple and effective respiratory support modality used to support neonates with respiratory failure and can be used in low-income and middle-income countries. The goal of this study was to describe implementation of the Silverman-Andersen respiratory severity score (RSS) and bubble CPAP in a rural Ugandan neonatal NICU. We sought to determine whether physicians and nurses in a low-income\/middle-income setting would assign similar RSS in neonates after an initial training period and over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We describe the process of training NICU staff to use the RSS to assist in decision making regarding initiation, titration, and termination of bubble CPAP for neonates with respiratory distress. Characteristics of all neonates with respiratory failure treated with bubble CPAP in a rural Ugandan NICU from January to June 2012 are provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Nineteen NICU staff members (4 doctors and 15 nurses) received RSS training. After this, the Spearman correlation coefficient for respiratory severity scoring between doctor and nurse was 0.73. Twenty-one infants, all &lt; 3 d of age, were treated with CPAP, with 17 infants starting on the day of birth. The majority of infants (16\/21, 76%) were preterm, 10 (48%) were &lt;1,500 g (birthweight), and 13 (62%) were outborn. The most common diagnoses were respiratory distress syndrome (16\/21, 76%) and birth asphyxia (5\/21, 24%). The average RSS was 7.4 \u00b1 1.3 before starting CPAP, 5.2 \u00b1 2.3 after 2\u20134 h of CPAP, 4.9 \u00b1 2.7 after 12\u201324 h of CPAP, and 3.5 \u00b1 1.9 before CPAP was discontinued. Duration of treatment with CPAP averaged 79 \u00b1 43 h. Approximately half (11\/21, 52%) of infants treated with CPAP survived to discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Implementing bubble CPAP in a low-income\/middle-income setting is feasible. The RSS may be a simple and useful tool for monitoring a neonate's respiratory status and for guiding CPAP management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.03438","type":"journal-article","created":{"date-parts":[[2014,11,11]],"date-time":"2014-11-11T23:58:57Z","timestamp":1415750337000},"page":"437-445","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":59,"title":["Implementation of Bubble CPAP in a Rural Ugandan Neonatal ICU"],"prefix":"10.1177","volume":"60","author":[{"given":"Ryan M","family":"McAdams","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, Washington."},{"name":"Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna B","family":"Hedstrom","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, Washington."},{"name":"Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M","family":"DiBlasi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill E","family":"Mant","sequence":"additional","affiliation":[{"name":"Paediatrics Department, York Hospital, York, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Nyonyintono","sequence":"additional","affiliation":[{"name":"Pediatrics, Kiwoko Hospital, Luweero, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine D","family":"Otai","sequence":"additional","affiliation":[{"name":"Pediatrics, Kiwoko Hospital, Luweero, Uganda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie A","family":"Lester","sequence":"additional","affiliation":[{"name":"The ISIS Foundation, Edmonds, Washington."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maneesh","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, Washington."},{"name":"Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,11,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5980"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3443"},{"issue":"4","key":"e_1_3_2_5_2","first-page":"CD002770","article-title":"Mechanical ventilation for newborn infants with respiratory failure due to pulmonary disease","author":"Henderson-Smart DJ","year":"2002","unstructured":"Henderson-Smart DJ, , Wilkinson A, , Raynes-Greenow CH. Mechanical ventilation for newborn infants with respiratory failure due to pulmonary disease. Cochrane Database Syst Rev, 2002;(4):CD002770.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/siny.2002.0132"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2009.28"},{"issue":"2","key":"e_1_3_2_8_2","first-page":"CD002271","article-title":"Continuous distending pressure for respiratory distress syndrome in preterm infants","author":"Ho JJ","year":"2002","unstructured":"Ho JJ, , Subramaniam P, , Henderson-Smart DJ, , Davis PG. Continuous distending pressure for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev, 2002(2):CD002271.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01376"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1179\/146532810X12637745452356"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmi109"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1179\/1465328110Y.0000000001"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0086327"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.09541209"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.17.1.1"},{"key":"e_1_3_2_16_2","unstructured":"Uganda Bureau of Statistics. 2002 Uganda population and housing census: population size and distribution 2002. http:\/\/www.ubos.org\/onlinefiles\/uploads\/ubos\/pdf%20documents\/2002%20CensusPopnSizeGrowthAnalyticalReport.pdf. Accessed October 9 2014."},{"key":"e_1_3_2_17_2","unstructured":"Uganda Bureau of Statistics. Uganda demographic and health survey 2011. http:\/\/www.ubos.org\/onlinefiles\/uploads\/ubos\/UDHS\/UDHS2011.pdf. Accessed October 9 2014."},{"key":"e_1_3_2_18_2","volume-title":"Disease and Mortality in Sub-Saharan Africa","author":"Jamison DT","year":"2006","unstructured":"Jamison DT, , Feachem RG, , Makgoba MW, , Bos ER, , Baingana FK, , Hofman KJ, , Rogo KO, editors. Disease and Mortality in Sub-Saharan Africa, 2nd edition. 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