A Low-Resource Oxygen Blender Prototype for Use in Modified Bubble CPAP Circuits: Results from Design Feasibility Workshops

Andrew G. Wu Division of Critical Care Medicine, Boston Children’s Hospital, Boston, Massachusetts;

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Sreyleak Luch Chenla Children’s Healthcare, Kratie, Krong Kracheh, Cambodia;

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Jared R. Floersch Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota;

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Adam Keester Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota;

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Tina M. Slusher Department of Pediatrics Global Pediatrics, University of Minnesota, Minneapolis, Minnesota;
Department of Pediatrics Pediatric Critical Care Medicine, University of Minnesota, Minneapolis, Minnesota;
Department of Pediatrics, Hennepin Healthcare, Minneapolis, Minneapolis;

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Gwenyth A. Fischer Department of Pediatrics Pediatric Critical Care Medicine, University of Minnesota, Minneapolis, Minnesota;

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Joseph E. Hale Technological Leadership Institute, University of Minnesota, Minneapolis, Minnesota

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Ashley R. Bjorklund Department of Pediatrics Global Pediatrics, University of Minnesota, Minneapolis, Minnesota;
Department of Pediatrics Pediatric Critical Care Medicine, University of Minnesota, Minneapolis, Minnesota;
Department of Pediatrics, Hennepin Healthcare, Minneapolis, Minneapolis;

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ABSTRACT.

Bubble CPAP is used in low-resource settings to support children with pneumonia. Low-cost modifications of bubble CPAP using 100% oxygen introduces the risk of hyperoxia. Our team developed a low-cost, readily constructible oxygen blender to lower the oxygen concentration. The next step in development was to test its construction among new users and ascertain three outcomes: construction time, outflow oxygen concentration, and an assessment of the user experience. Workshops were conducted in two countries. Instructions were delivered using a live demonstration, a video, and written instructions in the respective native language. Twelve volunteers participated. Average construction times were 24 minutes for the first attempt and 15 minutes for the second. The oxygen concentrations were 53–63% and 41–51% for the 5 and 10 mm entrainment ports, respectively. This novel, low-cost oxygen blender for bubble CPAP can be constructed among new users with reliable performance across devices.

Author Notes

Address correspondence to Andrew G. Wu, Division of Critical Care Medicine, Boston Children’s Hospital, 300 Longwood Ave., Boston, MA 02115. E-mail: andrew.wu@childrens.harvard.edu

Financial support: This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant number UL1TR002494.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences. Additional support was provided by The Pediatric Device Innovation Consortium at the University of Minnesota and the Frank J. and Eleanor A. Maslowski Charitable Trust.

Authors’ addresses: Andrew G. Wu, Division of Critical Care Medicine, Boston Children’s Hospital, Boston, MA, E-mail: andrewwu@umn.edu. Sreyleak Luch, Chenla Children’s Healthcare, Kratie, Krong Kracheh, Cambodia, E-mail: sreyleak@gmail.com. Jared R. Floersch and Adam Keester, Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, E-mails: floer010@umn.edu and keest001@umn.edu. Tina M. Slusher and Ashley R. Bjorklund, Department of Pediatrics Global Pediatrics, University of Minnesota, Minneapolis, MN, Department of Pediatrics Pediatric Critical Care Medicine, University of Minnesota, Minneapolis, MN, and Department of Pediatrics, Hennepin Healthcare, Minneapolis, Minneapolis, MN, E-mails: tslusher@umn.edu and bals0064@umn.edu. Gwenyth A. Fischer, Department of Pediatrics Pediatric Critical Care Medicine, University of Minnesota, Minneapolis, MN, E-mail: fisch662@umn.edu. Joseph E. Hale, Technological Leadership Institute, University of Minnesota, Minneapolis, MN, E-mail: halex012@umn.edu.

  • 1.

    WHO, 2016. Pneumonia. Geneva, Switzerland: World Health Organization.

  • 2.

    Liu L et al.; Child Health Epidemiology Reference Group of WHO and UNICEF, 2012. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 379: 2151–2161.

    • PubMed
    • Export Citation
  • 3.

    Lozano R et al., 2012. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2095–2128.

    • PubMed
    • Export Citation
  • 4.

    Liu L et al., 2016. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. Lancet 388: 30273035.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Boyd J , 2014. Clinical Study Finds ‘Bubble CPAP’ Boosts Neonatal Survival Rates [Website]. Rice University. Available at: http://news.rice.edu/2014/01/29/clinical-study-finds-bubble-cpap-boosts-neonatal-survival-rates-2/.

    • PubMed
    • Export Citation
  • 6.

    Lee KS , Dunn MS , Fenwick M , Shennan AT , 1998. A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in premature neonates ready for extubation. Neonatology 73: 6975.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Duke T et al., 2016. Oxygen Therapy for Children. Geneva, Switzerland: World Health Organization.

  • 8.

    Helmerhorst HJF , Schultz MJ , van der Voort PHJ , de Jonge E , van Westerloo DJ , 2015. Bench-to-bedside review: the effects of hyperoxia during critical illness. Crit Care 19: 284.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Stolmeijer R , Bouma HR , Zijlstra JG , Drost-de Klerck AM , Ter Maaten JC , Ligtenberg JJM , 2018. A systematic review of the effects of hyperoxia in acutely ill patients: should we aim for less? BioMed Res Int 2018: 7841295.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Tan A , Schulze A , O’Donnell CP , Davis PG , 2005. Air versus oxygen for resuscitation of infants at birth. Cochrane Database Syst Rev CD002273.

  • 11.

    Floersch J et al., 2020. A low-resource oxygen blender prototype for use in modified bubble CPAP circuits. J Med Device 14: 015001.

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