ABSTRACT
OBJECTIVE: Nasal Intermittent Positive Pressure Ventilation (NIPPV) is an effective therapy for infants in respiratory distress. We here report the safety of a novel, low-cost, non-electric bubble NIPPV device in comparison with bubble NCPAP. STUDY DESIGN: At Paramitha Children's Hospital (Hyderabad, India), preterm (n = 60) neonates with moderate respiratory distress were pragmatically allocated to bubble NCPAP (5-8 cm H2O) or bubble NIPPV (Phigh 8-12 cm H2O/Plow 5-8 cm H2O) based on staff and equipment availability. Primary outcomes to assess safety included clinically relevant pneumothorax, nasal septal necrosis, or abdominal distention. RESULTS: One patient in each arm developed minor nasal septal injury (grade 3 on NCPAP, grade 2 on NIPPV); no patients in either arm developed a clinically significant pneumothorax or abdominal distention. CONCLUSION: The similar rates of nasal septal injury, pneumothorax and abdominal distention suggest that bubble NIPPV has a similar safety profile as bubble NCPAP for preterm infants in respiratory distress.
Subject(s)
Continuous Positive Airway Pressure , Infant, Premature , Intermittent Positive-Pressure Ventilation , Respiratory Distress Syndrome, Newborn , Humans , Infant, Newborn , Respiratory Distress Syndrome, Newborn/therapy , Continuous Positive Airway Pressure/adverse effects , Continuous Positive Airway Pressure/methods , Intermittent Positive-Pressure Ventilation/methods , Intermittent Positive-Pressure Ventilation/adverse effects , Female , Male , Pneumothorax/therapy , Pneumothorax/etiology , India , Nasal SeptumABSTRACT
The events of recent years have affected the landscape of global child health education (GCHE) in the United States. War, racism, forced displacement, and the coronavirus disease 2019 (COVID-19) pandemic had global repercussions that reached US GCHE. The aim of this article is to examine the effect of these events on the landscape of GCHE in the US. Key areas of GCHE have been reframed, reshaped, and accelerated by these events. Travel restrictions accelerated virtual learning opportunities. Core curriculum needed to be reconsidered to address antiracism, equity, and decolonization. Expansion of GCHE activities, including local-global electives, was needed to meet increased resident demand and help address local community needs. Inequities in international partnerships were further highlighted, requiring new approaches. Global research education and practices were also affected with a rapid expansion in virtual opportunities and further development of education in equitable research practices. [Pediatr Ann. 2023;52(9):e324-e329.].