A high-value, low-cost bubble continuous positive airway pressure system for low-resource settings: technical assessment and initial case reports

PLoS One. 2013;8(1):e53622. doi: 10.1371/journal.pone.0053622. Epub 2013 Jan 23.


Acute respiratory infections are the leading cause of global child mortality. In the developing world, nasal oxygen therapy is often the only treatment option for babies who are suffering from respiratory distress. Without the added pressure of bubble Continuous Positive Airway Pressure (bCPAP) which helps maintain alveoli open, babies struggle to breathe and can suffer serious complications, and frequently death. A stand-alone bCPAP device can cost $6,000, too expensive for most developing world hospitals. Here, we describe the design and technical evaluation of a new, rugged bCPAP system that can be made in small volume for a cost-of-goods of approximately $350. Moreover, because of its simple design--consumer-grade pumps, medical tubing, and regulators--it requires only the simple replacement of a <$1 diaphragm approximately every 2 years for maintenance. The low-cost bCPAP device delivers pressure and flow equivalent to those of a reference bCPAP system used in the developed world. We describe the initial clinical cases of a child with bronchiolitis and a neonate with respiratory distress who were treated successfully with the new bCPAP device.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Disease
  • Bronchiolitis / pathology
  • Bronchiolitis / therapy*
  • Continuous Positive Airway Pressure / economics
  • Continuous Positive Airway Pressure / instrumentation*
  • Developing Countries
  • Humans
  • Infant
  • Infant, Newborn
  • Oxygen Inhalation Therapy / economics
  • Oxygen Inhalation Therapy / instrumentation*
  • Respiratory Distress Syndrome, Newborn / pathology
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Treatment Outcome

Grant support

This paper is made possible through the generous support of the Saving Lives at Birth Partners: the United States Agency for International Development (USAID), the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges of Canada, and the World Bank. It was prepared by William Marsh Rice University and does not necessarily reflect the views of the Saving Lives at Birth Partners. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.