P2B169: Development and Analysis of a Novel Field-expedient “bubble Bipap” Device for the Treatment of Respiratory Distress in Austere Settings

Background: Respiratory distress syndrome (RDS) remains a leading cause of death among infants born prematurely in low-income countries. The mortality rate of 40–60% in this population is approximately 10-fold higher than that of wealthy nations largely due to the lack of access to advanced respiratory support therapies. Bi-level positive airway pressure (BiPAP) machines have been widely used in hospitals for patients requiring more ventilatory support than a nasal cannula or continuous positive airway pressure machine (CPAP) can provide. However, in austere environments, access to standard BiPAP machines may be limited. There is an urgent need for a portable, reliable, and easily assembled technology to provide respiratory support for infants and children in resource-limited settings. Our objective is to develop a novel, open-source, low-cost “bubble BiPAP” device and demonstrate its ability to effectively deliver specific respiratory parameters.

Methods: A field-expedient “bubble BiPAP” device was manufactured using a modified nasal cannula, servo motor, microcontroller and a water-filled bucket. Using constant air flow provided by an air compressor, the device generates a controlled fluctuating pressure at the nasal prongs by varying the depth of the distal limb under water. Bench testing assessed the ability to maintain a consistent respiratory rate and target pressure at the nasal prongs. The electronic parts necessary for constructing the device are readily available on the consumer market and cost less than $10 in total.

Results: Pilot testing demonstrated close correlation between depth of the distal end of the nasal cannula and pressure at the nares. The device maintained a 10/5 cm-H2O inspiratory and expiratory pressure range at 20 breaths per minute, which is consistent with traditional BiPAP ventilation.

Conclusion: Our novel field-expedient “bubble BiPAP” consistently provided pressures similar to traditional BiPAP modes of respiratory support, signifying a first step in validation of device function. Further research and refinement of the device is warranted to optimize its performance and demonstrate safety and applicability in real-world scenarios. The low cost open-source design may contribute to the advancement of respiratory support technologies in resource-constrained settings.