Michael Hawkes1,2,3,4,5, Akos Somoskovi6,7, Dickson Otiangala8, Nicholas O Agai8, Bernard Olayo8, Steve Adudans8, Chin Hei Ng6,7, Ryan Calderon6,7, Ella Forgie9, Christine Bachman6,7, Daniel Lieberman6,7, David Bell6,7,10. 1. Department of Pediatrics, University of Alberta, 3-588D Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada. mthawkes@ualberta.ca. 2. Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada. mthawkes@ualberta.ca. 3. Department of Global Health, School of Public Health, University of Alberta, Edmonton, Canada. mthawkes@ualberta.ca. 4. Stollery Science Lab, University of Alberta, Edmonton, Canada. mthawkes@ualberta.ca. 5. Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada. mthawkes@ualberta.ca. 6. Intellectual Ventures Laboratory, Bellevue, WA, USA. 7. Intellectual Ventures, Global Good Fund, Bellevue, WA, USA. 8. Center for Public Health and Development, Nairobi, Kenya. 9. Department of Pediatrics, University of Alberta, 3-588D Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada. 10. , Issaquah, WA, USA.
Abstract
BACKGROUND: Supplemental oxygen is an essential treatment for childhood pneumonia but is often unavailable in low-resource settings or unreliable due to frequent and long-lasting power outages. We present a novel medium pressure reservoir (MPR) which delivers continuous oxygen to pediatric patients through power outages. METHODS: An observational case series pilot study assessing the capacity, efficacy and user appraisal of a novel MPR device for use in low-resource pediatric wards. We designed and tested a MPR in a controlled preclinical setting, established feasibility of the device in two rural Kenyan hospitals, and sought user feedback and satisfaction using a standardized questionnaire. RESULTS: Preclinical data showed that the MPR was capable of bridging power outages and delivering a continuous flow of oxygen to a simulated patient. The MPR was then deployed for clinical testing in nine pediatric patients at Ahero and Suba Hospitals. Power was unavailable for 2% of the total time observed due to 11 power outages (median 4.6 min, IQR 3.6-13.0 min) that occurred during treatment with the MPR. Oxygen flowrates remained constant across all 11 power outages. Feedback on the MPR was uniformly positive; all respondents indicated that the MPR was easy to use and provided clinically significant help to their patients. CONCLUSION: We present a MPR oxygen delivery device that has the potential to mitigate power insecurity and improve the standard of care for hypoxemic pediatric patients in resource-limited settings.
BACKGROUND: Supplemental oxygen is an essential treatment for childhood pneumonia but is often unavailable in low-resource settings or unreliable due to frequent and long-lasting power outages. We present a novel medium pressure reservoir (MPR) which delivers continuous oxygen to pediatric patients through power outages. METHODS: An observational case series pilot study assessing the capacity, efficacy and user appraisal of a novel MPR device for use in low-resource pediatric wards. We designed and tested a MPR in a controlled preclinical setting, established feasibility of the device in two rural Kenyan hospitals, and sought user feedback and satisfaction using a standardized questionnaire. RESULTS: Preclinical data showed that the MPR was capable of bridging power outages and delivering a continuous flow of oxygen to a simulated patient. The MPR was then deployed for clinical testing in nine pediatric patients at Ahero and Suba Hospitals. Power was unavailable for 2% of the total time observed due to 11 power outages (median 4.6 min, IQR 3.6-13.0 min) that occurred during treatment with the MPR. Oxygen flowrates remained constant across all 11 power outages. Feedback on the MPR was uniformly positive; all respondents indicated that the MPR was easy to use and provided clinically significant help to their patients. CONCLUSION: We present a MPR oxygen delivery device that has the potential to mitigate power insecurity and improve the standard of care for hypoxemic pediatric patients in resource-limited settings.
Entities:
Keywords:
Africa; Electricity; Global health; Hypoxemia; Pneumonia
Authors: T Duke; S M Graham; M N Cherian; A S Ginsburg; M English; S Howie; D Peel; P M Enarson; I H Wilson; W Were Journal: Int J Tuberc Lung Dis Date: 2010-11 Impact factor: 2.373