A Novel Low-cost Bubble CPAP device with Pressure Monitoring and Controlling System for Low Resource Settings

Purpose: Africa contributed to one-third of the world’s neonatal mortality burden. In the sub-Saharan region, premature births are a major problem. In this case, the baby is more likely to have breathing problems, which may require more oxygen. When compared to other respiratory supportive methods for treating infants in respiratory distress, bubble continuous positive air pressure (bCPAP) is a safe and effective system that is used in many resource-limited neonatal units. Despite its established safety, efficacy, and relative simplicity, CPAP treatment is not widely available for newborns and infants in low-income settings. Moreover, the accumulation of condensate in the patient's exhalation limb during operation could significantly increase pressure delivered to the body, which can lead to severe respiratory failure in the infant. Currently, existing devices in low-resource settings are expensive, and they were not able to control the accumulation of condensate in the exhalation limb. This quietly increases the mortality rate of neonates in the area. Therefore, the objective of this research was to design and develop a novel low-cost bubble CPAP device that can monitor and control the pressure delivered to infants focusing on low resource settings. The device provides humidified, blended, and pressurized gas for the patient. Design and Methods: The proposed final solution is a bubble CPAP machine that monitors and controls the excess pressure caused by condensate accumulations in the expiratory tube by using a pressure sensor and a two-way solenoid valve. The system incorporates core components like Arduino microcontroller which control the system depending upon the uploaded code, the pressure sensor that measures the airway pressure continuously, the solenoid valve that opens alternatively depending on the accumulation of the condensate pressure, the LCD and buzzer for displaying the pressure reading and giving an alarm for uncontrolled condition respectively. When the neonate expires, the pressure sensor inside the expiratory limb measure the instant positive end-expiratory pressure (PEEP) and send it to the microcontroller. The microcontroller decides whether to turn the relay (controls the electric power to the 2 - solenoid valve) to switch the path of expiration between the two expiratory tubes connected to the valves outlets. This depends on the pressure reading and the cutoff pressure value manually inserted (based on oxygen blending value) by the physician. Results: The prototype was built and subjected to various tests and iterations to determine the device's effectiveness. The test was performed on the artificial lung model using a ballon and manually squeezed at different breathing rates. It was tested for accuracy, safety, cost, ease of use, and durability. The prototype was accurate in 8 iterations at 8 different depths that were made to monitor and control the pressure. It was safe and provided suitable pressure for the neonate, and the prototype was built in less than 193 USD. Conclusions: The performance testing of the device demonstrated accurate and safe control and monitoring of CPAP and oxygen level with humidity levels safe for infants. This helps to reduce the neonate injury that may occur due to respiratory distress syndrome. Practice Implications: The proposed design allows physicians, to easily monitor and control the accumulation of condensate in the exhalation limb of the CPAP machine accurately and safely.