TOP 13 - Integration of a novel bCPAP System and Package of Care in a Community Hospital and during Water Transport in the Marajo Island Region of the Brazilian Amazon

Publication Number: 2765.TOP 13

Rebecca Kassab, MassGeneral Hospital for Children, Boston, MA, United States; Lia M. Brasil, Vayu Global Health Foundation, Medford, MA, United States; Bia Marques, Vayu Global Health Foundation, Rio de Janeiro, Rio de Janeiro, Brazil; Aurimery Gomes. Chermont, Universidade Federal do Pará, Belém, Para, Brazil; Lindinalva Brasil, Fundação Santacasa de Misericordia do Pará, Belém, Para, Brazil; Lorraine Freed. Garg, Vayu Global Health Foundation, NEWTON CENTER, MA, United States; Thomas F. Burke, Harvard Medical School, Medford, MA, United States

Background: Respiratory distress is a leading cause of neonatal morbidity and mortality, particularly among premature neonates in low-resource settings with limited access to respiratory support. In the Brazilian municipality of Portel, geographic isolation and limited infrastructure create substantial barriers to healthcare delivery. Boat ambulances are often the only means of transporting critically ill neonates to higher level facilities, yet most are unequipped with basic respiratory support tools. To mitigate this challenge, the Vayu bCPAP System, a low-cost, electricity-free device, was implemented at Portel General Hospital and on four boat ambulances in 2024.

Objective: This study evaluates the integration and utilization of the Vayu bCPAP System in both hospital and water-transport settings and its impact on neonatal care in this remote, resource-limited region.

Design/Methods: Intervention:
Portel General Hospital (PCH) functions as a community healthcare facility and only has a pediatric emergency room and no pediatricians. In July 2024, the facility was provided with two Vayu bCPAP Systems. Subsequently, between September and November 2024, four boat ambulances, stationed in Portel area, were outfitted with oxygen tanks, flowmeters, neonatal pulse oximeters, and Vayu bCPAP Systems. Additionally, more than 30 healthcare professionals, including hospital staff and ambulance providers, received didactic and hands on training on use of the Vayu bCPAP System.

Study Design and Analysis:
This study includes both quantitative and qualitative data collection and analysis. Neonates and infants who received bCPAP therapy were included, and patient characteristics and clinical outcomes were abstracted from a data tracking form developed during the initial implementation phase. Descriptive statistics were generated using Microsoft Excel. Additionally, semi-structured interviews with twenty healthcare providers involved in the integration and use of the Vayu bCPAP System will be analyzed using qualitative methodology. Transcripts will be coded inductively, and thematic analysis will be performed using Dedoose software.