Use of a novel bubble CPAP device during long-distance neonatal transport in the Brazilian Amazon: a report of two cases

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Abstract Background Small and sick newborns often require transport to higher-level facilities for care of acute conditions such as respiratory distress syndrome of prematurity (RDS). Timely treatment with noninvasive continuous positive airway pressure (CPAP) improves outcomes of neonates with RDS, but little has been described on the use of CPAP during transport in low-resource settings. In July and November of 2024, our team trained medical staff and donated novel bubble CPAP devices to a general hospital and local ambulance service in a remote region of the Brazilian Amazon. Case presentation In this Case Report, we describe two critically ill newborns who were treated with a novel bubble CPAP device while transported long distances on the Amazon River. We additionally review the essential elements necessary for quality care of neonates during transport. Conclusions These two cases may demonstrate a new opportunity for care of small and sick newborns in similar settings.