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- W1874806094 abstract "Experience with treating respiratory distress in neonates suggests that bubble continuous positive airway pressure (CPAP) might be a very effective treatment for severe pneumonia in children. 2 Duke T CPAP: a guide for clinicians in developing countries. Paediatr Int Child Health. 2014; 34: 3-11 Crossref PubMed Scopus (51) Google Scholar In The Lancet, Mohammond Chisti and colleagues 3 Chisti MJ Salam MA Smith JH et al. Bubble continuous positive airway pressure for children with severe pneumonia and hypoxaemia in Bangladesh: an open, randomised controlled trial. Lancet. 2015; (published online Aug 19.)http://dx.doi.org/10.1016/S0140-6736(15)60249-5 PubMed Google Scholar report a randomised trial carried out in Bangladesh, in which 225 children aged under 5 years with severe pneumonia were enrolled, comparing bubble CPAP and high-flow oxygen therapy with standard low-flow oxygen therapy. After 21 treatment failures (the primary endpoint) and 13 deaths (a secondary endpoint) in two treatment groups combined, the bubble CPAP group had about a quarter the treatment failure rate and a quarter the mortality rate of the low-flow oxygen therapy group. Should such a trial be continued and risk excess deaths of children randomly assigned to low-flow oxygen therapy? Or should it be stopped early, despite the small sample size, and risk excess deaths in the future by providing misleading evidence, or by delaying widespread uptake of an effective treatment? Bubble continuous positive airway pressure for children with severe pneumonia and hypoxaemia in Bangladesh: an open, randomised controlled trialOxygen therapy delivered by bubble CPAP improved outcomes in Bangladeshi children with very severe pneumonia and hypoxaemia compared with standard low-flow oxygen therapy. Use of bubble CPAP oxygen therapy could have a large effect in hospitals in developing countries where the only respiratory support for severe childhood pneumonia and hypoxaemia is low-flow oxygen therapy. The trial was stopped early because of higher mortality in the low-flow oxygen group than in the bubble CPAP group, and we acknowledge that the early cessation of the trial reduces the certainty of the findings. Full-Text PDF" @default.
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- W1874806094 date "2015-09-01" @default.
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- W1874806094 title "Bubble CPAP for pneumonia: perils of stopping trials early" @default.
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- W1874806094 doi "https://doi.org/10.1016/s0140-6736(15)60691-2" @default.
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