Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Children Aged 159 Months with Severe Pneumonia and Hypoxemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Date
2025-06
Journal Title
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Publisher
Indian Academy of Pediatrics
Abstract
OBJECTIVE Con?nuous posi?ve airway pressure (CPAP) is a standard treatment for children with moderate to severe respiratory distress; however, ven?lators are o?en unavailable in developing countries. Bubble CPAP (bCPAP) is considered a simple, cost effec?ve and less invasive alterna?ve to CPAP, however, its efficacy has not been assessed for children with pneumonia un?l recently. This meta-analysis aims to compare the effec?veness of bCPAP with low-flow oxygen for trea?ng severe pneumonia and hypoxemia in children. METHODS PubMed, EMBASE, Cochrane Library, Web of Science, and CENTRAL were searched to iden?fy eligible randomized controlled trials reported up to March 23, 2024. Outcomes were reported as risk ra?os (RRs) or mean difference (MD) and confidence intervals (CIs) using Review Manager so?ware. P value < 0.05 was considered sta?s?cally significant. RESULTS Three studies with 2030 pa?ents were included and revealed no significant difference between bCPAP and control in overall mortality [RR (95% CI) 0.46 (0.09, 2.32); P = 0.348], death during hospital stay [0.48 (0.02, 9.09), P = 0.619], composite primary outcome [0.48 (0.12, 1.97), P = 0.301], pneumothorax [1.94 (0.16, 23.11), P = 0.601], leaving hospital against medical advice [0.63 (0.16, 2.39), P = 0.489], and length of hospital stay [MD (95%CI) 0.15 days (? 0.66, 0.96), P = 0.706]. Children on bCPAP had significantly fewer events of severe hypoxemia [RR (95% CI) 0.22 (0.10, 0.49), P < 0.001], and less requirement for mechanical ven?la?on [RR (95% CI) 0.38 (0.15, 0.99), P = 0.048]. CONCLUSIONS bCPAP is not superior to low-flow oxygen for improving survival and reducing hospital stay in children with pneumonia, albeit the need for mechanical ven?la?on decreases.
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Keywords
CPAP, Bubble CPAP, Severe pneumonia
Citation
Tanashat Mohammad, Manasrah AlMothana, Bataineh Omar Abdullah, Abdelrazek Ahmad, Abouzid Mohamed. Effectiveness of Bubble Continuous Positive Airway Pressure for Treatment of Children Aged 159 Months with Severe Pneumonia and Hypoxemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Indian Pediatrics. 2025 Jun; 62(6): 440-450