Use of indigenous bubble CPAP during swine flu pandemic in Pune, India

Aarti Kinikar, Rajesh Kulkarni, Chhaya Valvi, Nikhil Gupte

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective: To assess the effectiveness of an indigenously assembled Nasal Bubble CPAP (NB-CPAP) in children during present swine flu pandemic presenting with acute hypoxemic respiratory failure; in improving gas exchange and vital signs; and assess method safety. Methods: Thirty Six children with acute hypoxemic respiratory failure admitted to swine flu ICU during the present H1NI pandemic were included (18 confirmed H1N1 positive and 18 confirmed H1N1 negative). After a baseline Arterial Blood Gas, all children received Oxygen via indigenous NB-CPAP Circuit which gave expiratory positive airway pressure of 5 cm water and delivered an FiO 2 of around 70%. Vital signs, pH, PaO 2, PaCO 2, PO 2/FiO 2 and O 2 saturation were recorded at start and at 6 h into the study. Results: Median age of the patients was 18 months (58% males, 42% females). Respiratory rate and heart rate improved significantly with indigenous NB-CPAP after 6 h of treatment compared with admission (p∈<∈0.0001 and p∈<∈0.001), respectively. At the end of 6 h on NB-CPAP,PaO 2 (p∈<∈0.0001), PCO 2 (p∈<∈0. 0001), PO 2/FiO 2 (p∈<∈0.0002) and O 2 saturation (p∈<∈0.001) improved significantly. Median duration of NB-CPAP use was 2 days and none required endotracheal intubation. The median hospital stay was 7 days. Conclusions: Indigenous NB-CPAP improves hypoxemia and signs and symptoms in hemodynamically stable children with acute respiratory failure due to influenza like illness. It is a cost-effective, safe, well tolerated circuit in highly demanding pandemic situations and may prevent progression to intubation.

Original languageEnglish (US)
Pages (from-to)1216-1220
Number of pages5
JournalIndian journal of pediatrics
Issue number10
StatePublished - Oct 2011
Externally publishedYes


  • India
  • Indigenous Nasal Bubble CPAP
  • Non- invasive ventilation
  • Pediatric acute hypoxemic respiratory failure
  • Swine flu pandemic

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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