Outcomes in neonates with respiratory distress syndrome using SAANS NIV
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20222025Keywords:
RDS, CPAP, Neonatal mortality, LMICsAbstract
Background: In low-and-middle income countries (LMICs), neonatal mortality is still unacceptably high compared to developed nations. Respiratory distress syndrome (RDS) is one of the major contributors to high mortality rates in this population. This study was conducted to analyze the effects of Saans non-invasive ventilation (NIV), an infrastructure-independent continuous positive airway pressure (CPAP) and resuscitation device, on neonatal mortality and cost compared to current practices.
Methods: This single-center, prospective, observational analytical study was to determine the efficacy of Saans NIV in delivering CPAP and resuscitation therapy to neonates diagnosed with RDS.
Results: An 82% success rate was recorded while using Saans NIV for CPAP and resuscitation therapy in this study, which was far superior to the global average. This also means that 82% of the patients included in this study avoided invasive mechanical ventilation. After a cost analysis, we concluded that invasive mechanical ventilation would cost $3478 USD for treatment vs. just $155 USD for patients treated with traditional CPAP therapy.
Conclusions: Infrastructure-independent devices such as Saans NIV are game-changers in LMICs. Saans NIV makes CPAP and safe resuscitation therapy available in resource-constrained settings and during transport. This study showcases that Saans NIV can significantly reduce the need for invasive mechanical ventilation and the costs associated with treating neonates.
References
Neonatal mortality-UNICEF DATA. 2021. Available at: https://data.unicef.org/topic/child-survival/ neonatal-mortality/. Accessed 28 April 2022.
Riyas PK, Vijayakumar KM, Kulkarni ML. Neonatal mechanical ventilation. Indian J Pediatr. 2003;70:537-40.
Child survival and the SDGs-UNICEF DATA, 2022. Available at: https://data.unicef.org/topic/child-survival/child-survival-sdgs/#:~:text=The%20 proposed%20SDG%20target%20for,deaths%20per%201%2C000%20live%20births. Accessed 28 April 2022.
Sangeeta ST, Rajesh KC, Anurakti S. Study of early predictors of fatality in mechanically ventilated neonates in NICU. Online J Health Allied Sci. 2009;8:3-9.
Hossain MM, Mahfuza S, Abdullah MA, Hassan MN, Sahidullah M. Predictors of mortality in ventilated neonates in intensive care unit. Bangladesh J Child Health. 2009;33:77-82.
Mathur NB, Garg P, Mishra TK. Predictors of fatality in neonates requiring mechanical ventilation. Indian Pediatr. 2005;42:645-51.
WHO Recommendations on Interventions to Improve Preterm Birth Outcomes. 2015. Available at https://apps.who.int/iris/bitstream/handle/10665/183055/WHO_RHR_15.16_eng.pdf?sequence=1. Accessed 28 April 2022.
Anitha GF, Velmurugan L, Sangareddi S, Nedunchelian K, Selvaraj V. Effectiveness of flow inflating device in providing Continuous Positive Airway Pressure for critically ill children in limited-resource settings: A prospective observational study. Indian J Cri Care Med. 2006;20(8):441-7.
My Doctor Online. 2022. Available at: https://mydoctor.kaiserpermanente.org/ncal/structured-content/Condition_Respiratory_Distress_ Syndrome_-_Neonatology.xml?co=%2Fregions %2Fncal. Accessed 28 April 2022.
Kambarami R, Chidede O, Chirisa M. Neonatal intensive care in a developing country: Outcome and factors associated with mortality. Cent Afr J Med. 2000;46:205-7.
WHO Recommendations on Interventions to Improve Preterm Birth Outcomes. 2015. Available at: https://apps.who.int/iris/bitstream/handle/10665 /183055/WHO_RHR_15.16_eng.pdf?sequence=1. Accessed 28 April 2022.
Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet J-M, Carlin JB et al. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008;358(7):700-8.
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.
Ohnstad MO, Stensvold HJ, Tvedt CR, Rønnestad AE. Duration of Mechanical Ventilation and Extubation Success among Extremely Premature Infants. Neonatology. 2021;118:90-7.