Browsing by Author "Heenan, Megan"

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    Avoid equipment graveyards: rigorous process to improve identification and procurement of effective, affordable, and usable newborn devices in low-resource hospital settings
    (Springer Nature, 2023) Asma, Elizabeth; Heenan, Megan; Banda, George; Kirby, Rebecca P.; Mangwiro, Lucky; Acemyan, Claudia Ziegler; Palamountain, Kara M.; Kortum, Philip; Kawaza, Kondwani; Oden, Z. Maria; Richards-Kortum, Rebecca; Brandt, Alexsandra; Kumara, Danica; Jin, Li; Khalid, Ali; Osoo, Cliff; Bisceglia, Nicki; Gate, Vince; Valle, Maureen; Mjumira, Rowland; Chapin, Abby; Shapiro, Alyssa; Samuel, Christina; Kimmey, David; Belton, M. Grant; Wang, Yifan Jack; Johnston, Jake; Anderson, Jessica; Bailey, Joseph; Coyle, Josh; Gordon, Kaede; Weld, Madeleine Tadros; Bond, Meaghan; Mitchell, Natalie; Mobarhan, Sara Liaghati; Salter, Sarah Elina; Matin, Shababa B.; Saenz, Sonia E. Sosa; Kalikoff, Sylvie; Boles, Taylor; Technical Collaborative Authorship Group; Rice360 Institute for Global Health Technologies
    Millions of newborns die annually from preventable causes, with the highest rates occurring in Africa. Reducing neonatal mortality requires investment to scale hospital care, which includes providing hospitals with appropriate technology to care for small and sick newborns. Expensive medical devices designed for high-resource settings often fail to withstand conditions in low-resource hospitals, including humidity, dust, frequent user turnover, complex maintenance, lack of stable power, or difficulty sourcing expensive consumables. Rigorous evaluation protocols are needed to identify effective, affordable, rugged, and easy-to-use medical devices appropriate for quality hospital-based newborn care in low-resource hospitals.
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    In vitro comparison of performance including imposed work of breathing of CPAP systems used in low-resource settings
    (Public Library of Science, 2020) Heenan, Megan; Rojas, Jose D.; Oden, Z. Maria; Richards-Kortum, Rebecca; Bioengineering; Rice 360 Institute for Global Health
    Respiratory distress due to preterm birth is a significant cause of death in low-resource settings. The introduction of continuous positive airway pressure (CPAP) systems to treat respiratory distress significantly reduced mortality in high-resource settings, but CPAP was only recently introduced in low-resource settings due to cost and infrastructure limitations. We evaluated pressure stability and imposed work of breathing (iWOB) of five CPAP systems used in low resource settings: the Fisher and Paykel bubble CPAP, the Diamedica baby CPAP, the Medijet nCPAP generator, and the first (2015) and second (2017) generation commercially available Pumani CPAPs. Pressure changes due to fresh gas flow were evaluated for each system by examining the relationship between flow and pressure at the patient interface for four pressures generated at the bottle (0, 3, 5, and 7 cm H2O); for the Medijet nCPAP generator, no bottle was used. The slope of the resulting relationship was used to calculate system resistance. Poiseuille’s law of resistance was used to investigate significant contributors to resistance. Resistance ranged from 0.05 to 1.40 ; three CPAP devices had resistances < 0.4 : the Fisher and Paykel system, the Diamedica system, and the second generation Pumani bubble CPAP. The other two systems, the Medijet nCPAP generator and the first generation Pumani bCPAP, had resistances >1.0 . Imposed WOB was measured using an ASL5000 test lung to simulate the breath cycle for an infant (5.5 kg), a term neonate (4.0 kg), and a preterm neonate (2.5 kg). Imposed WOB ranged from 1.4 to 39.5 mJ/breath across all systems and simulated infant sizes. Changes in pressure generated by fresh gas flow, resistance, and iWOB differ between the five systems evaluated under ideal laboratory conditions. The available literature does not indicate that these differences affect clinical outcomes.
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    Target product profiles for neonatal care devices: systematic development and outcomes with NEST360 and UNICEF
    (Springer Nature, 2023) Kirby, Rebecca P.; Molyneux, Elizabeth M.; Dube, Queen; McWhorter, Cindy; Bradley, Beverly D.; Gartley, Martha; Oden, Z. Maria; Richards-Kortum, Rebecca; Werdenberg-Hall, Jennifer; Kumara, Danica; Liaghati-Mobarhan, Sara; Heenan, Megan; Bond, Meaghan; Ezeaka, Chinyere; Salim, Nahya; Irimu, Grace; Palamountain, Kara M.; Manasyan, Albert; Worm, Anna; Zuechner, Antke; Chepkemoi, Audrey; Tembo, Bentry; Trubo, Casey; Mudenyanga, Chishamiso; Wald, Daniel; Goldfarb, David; Gicheha, Edith; Asma, Elizabeth; Ciccone, Emily; Mbale, Emmie; Gheorghe, Florin; Dumont, Guy; Naburi, Helga; Pernica, Jeffrey; Appiah, John; Strysko, Jonathan; Langton, Josephine; Lawn, Joy; Klein, Kate; Kawaza, Kondwani; Gandrup-Marino, Kristoffer; Lloyd, Lizel; Woo Kinshella, Maggie; Chise, Mamiki; Myszkowski, Marc; Mkony, Martha Franklin; Waiyego, Mary; Khoory, Matthew; Medvedev, Melissa; Chiume, Msandeni; Spotswood, Naomi; Mataruse, Noah; Lufesi, Norman; Lincetto, Ornella; Lavoie, Pascal; Mbuthia, Rachel; Chifisi, Rhoda; Owino, Rita; Moshiro, Robert; Mbwasi, Ronald; Akech, Sam; Shah, Sona; Reschwamm, Steffen; Adudans, Steve; Mogotsi, Thabiso; Karlen, Walter; Demeke, Zelalem; the TPP Survey, Consensus Meeting Participants Collaborative Authorship Group; Rice360 Institute for Global Health Technologies
    Medical devices are critical to providing high-quality, hospital-based newborn care, yet many of these devices are unavailable in low- and middle-income countries (LMIC) and are not designed to be suitable for these settings. Target Product Profiles (TPPs) are often utilised at an early stage in the medical device development process to enable user-defined performance characteristics for a given setting. TPPs can also be applied to assess the profile and match of existing devices for a given context.