Continuous positive airway pressure for children with undifferentiated respiratory distress in Ghana: an open-label, cluster, crossover trial

The Lancet Global Health
Patrick T WilsonRachel T Moresky

Abstract

In low-income and middle-income countries, invasive mechanical ventilation is often not available for children at risk of death from respiratory failure. We aimed to determine if continuous positive airway pressure (CPAP), a form of non-invasive ventilation, decreases all-cause mortality in children with undifferentiated respiratory distress in Ghana. This open-label, cluster, crossover trial was done in two Ghanaian non-tertiary hospitals where invasive mechanical ventilation is not routinely available. Eligible participants were children aged from 1 month to 5 years with a respiratory rate of more than 50 breaths per min in children 1-12 months old, or more than 40 breaths per min in children older than 12 months, and use of accessory muscles or nasal flaring. CPAP machines were allocated to one hospital during each study block, while the other hospital served as the control site. The initial intervention site was randomly chosen using a coin toss. 5 cm of water pressure was delivered via CPAP nasal prongs. The primary outcome measure was all-cause mortality rate at 2 weeks after enrolment in patients for whom data were available after 2 weeks. We also did post-hoc regression analysis and subgroup analysis of children by mala...Continue Reading

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Citations

May 13, 2017·The Lancet Global Health·Elizabeth Molyneux
Oct 10, 2018·Journal of Empirical Research on Human Research Ethics : JERHRE·Patrick T WilsonMarilyn C Morris
Dec 12, 2018·Current Opinion in Critical Care·Rebecca InglisMarcus J Schultz
Sep 16, 2017·Intensive Care Medicine·Andrew C ArgentSuchitra Ranjit
Jul 8, 2020·Pediatric Research·Saraswati KacheJoseph Carcillo
May 28, 2020·International nursing review·Jiayu WangKatie R Nielsen
May 23, 2020·World Journal of Pediatrics : WJP·Zhi-Li WangZheng-Xiu Luo
Aug 2, 2019·BMC Health Services Research·Kristen L SessionsEric D McCollum
Nov 18, 2020·Archives of Disease in Childhood·Akanksha VermaAnita Singh
Sep 22, 2019·Pediatrics·Jennifer CarnsRebecca Richards-Kortum

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