Effectiveness of bubble continuous positive airway pressure for treatment of children aged 1–59 months with severe pneumonia and hypoxaemia in Ethiopia: a pragmatic cluster-randomised controlled trial

The safety and efficacy of bubble continuous positive airway pressure (bCPAP) for treatment of childhood severe pneumonia outside tertiary care hospitals is uncertain. We did a cluster-randomised effectiveness trial of locally made bCPAP compared with WHO-recommended low-flow oxygen therapy in child...

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Bibliographic Details
Published in:The Lancet global health 2024-05, Vol.12 (5), p.e804-e814
Main Authors: Gebre, Meseret, Haile, Kassa, Duke, Trevor, Faruk, Md Tanveer, Kamal, Mehnaz, Kabir, Md Farhad, Uddin, Md Fakhar, Shimelis, Muluye, Beyene, Tigist, Solomon, Bethelhem, Solomon, Meles, Bayih, Abebe Genetu, Abdissa, Alemseged, Balcha, Taye Tolera, Argaw, Rahel, Demtse, Asrat, Weldetsadik, Abate Yeshidinber, Girma, Abayneh, Haile, Bitseat W, Shahid, Abu Sadat Mohammad Sayeem Bin, Ahmed, Tahmeed, Clemens, John D, Chisti, Mohammod Jobayer
Format: Article
Language:English
Subjects:
Child
Continuous Positive Airway Pressure
Ethiopia
Humans
Hypoxia - therapy
Oxygen - therapeutic use
Pneumonia - therapy
Respiration Disorders
Treatment Outcome
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Summary:The safety and efficacy of bubble continuous positive airway pressure (bCPAP) for treatment of childhood severe pneumonia outside tertiary care hospitals is uncertain. We did a cluster-randomised effectiveness trial of locally made bCPAP compared with WHO-recommended low-flow oxygen therapy in children with severe pneumonia and hypoxaemia in general hospitals in Ethiopia. This open, cluster-randomised trial was done in 12 general (secondary) hospitals in Ethiopia. We randomly assigned six hospitals to bCPAP as first-line respiratory support for children aged 1–59 months who presented with severe pneumonia and hypoxaemia and six hospitals to standard low-flow oxygen therapy. Cluster (hospital) randomisation was stratified by availability of mechanical ventilation. All children received treatment in paediatric wards (in a dedicated corner in front of a nursing station) with a similar level of facilities (equipment for oxygen therapy and medications) and staffing (overall, one nurse per six patients and one general practitioner per 18 patients) in all hospitals. All children received additional care according to WHO guidelines, supervised by paediatricians and general practitioners. The primary outcome was treatment failure (defined as any of the following: peripheral oxygen saturation
ISSN:2214-109X
2214-109X
DOI:10.1016/S2214-109X(24)00032-9