Bubble CPAP Used During Two Amazon Neonatal Transports

Two critically ill newborns received noninvasive continuous positive airway pressure through a novel bubble CPAP device during long-distance transport along the Amazon River in Brazil, according to a two-case report. The cases provide limited evidence that the device can be used during neonatal transport in a remote, low-resource setting, but they do not establish its safety, effectiveness or superiority over other approaches. Timely treatment with noninvasive continuous positive airway pressure, or CPAP, improves outcomes in neonates with respiratory distress syndrome.

However, the report notes that little has been described about using CPAP during transport in low-resource settings. The reported journeys followed a training and donation effort conducted in July and November 2024. The team trained medical staff and donated novel bubble CPAP devices to a general hospital and a local ambulance service in a remote region of the Brazilian Amazon.

In the two cases presented, critically ill newborns were treated with the device while being carried over long distances on the Amazon River. This case report also reviews the essential elements identified for maintaining quality care of neonates during transport. The authors describe the two journeys as a possible new opportunity for supporting small and sick newborns in similar settings.

The report therefore demonstrates a limited feasibility observation rather than proof of clinical benefit or reliable success in neonatal transport. Larger studies would be required to characterize the device’s role more broadly, although the present cases document an actual use of bubble CPAP during river transport in the Brazilian Amazon.

Subject of Research: Neonatal bubble CPAP during long-distance transport in the Brazilian Amazon

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

Article References: Layer, A., Brasil, L., Garg, L. F., & Burke, T. F. (2026). Use of a novel bubble CPAP device during long-distance neonatal transport in the Brazilian Amazon: a report of two cases. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07579-8

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07579-8

Keywords: neonatal transport, bubble CPAP, newborn respiratory support, respiratory distress syndrome, premature newborns, Brazilian Amazon, Amazon River, low-resource healthcare, case report, novel, bubble, CPAP