DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172067

Outcome of preterm babies with respiratory distress syndrome on nasal CPAP

Sunil B., Girish N., Manali Bhuyan

Abstract


Background: Continuous positive airway pressure (CPAP) has become a useful modality in management of respiratory distress in preterm babies. Nasal CPAP was found to be safe and effective means of treating mild and moderate RDS and apnoea of prematurity; Continuous Positive Airway Pressure (CPAP) is a cost-effective and minimal invasive respiratory support for the newborn. The aim of the study was to assess whether the introduction of continuous positive airway pressure (CPAP) results in improved respiratory outcomes in preterm neonates ≤36 weeks of gestation in KIMS hospital.

Methods: The study was an observational clinical study, undertaken in KIMS hospital, Bangalore, Karnataka, between November 2015 to October 2016. All babies born ≤36 weeks of gestational age with respiratory distress were included in this study. Chi-square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale between two or more groups and Non-parametric setting for Qualitative data analysis

Results: Seventy-seven premature newborn babies with ≤36 weeks of gestation were included in the study and were put on nasal CPAP. The incidence of CPAP failure was 22.1% (95% CI 14.27-32.54%). The proportion of neonates who required surfactant was 16.9% (10.14-26.77%) and the proportion of children who met with mortality was 6.5% (10.14-26.77%) in this study.

Conclusions: Early institution of CPAP in the management of RDS in premature neonates can significantly reduce the need for mechanical ventilation (MV) and surfactant therapy. 


Keywords


Continuous positive airway pressure, Non-invasive ventilation, Respiratory distress syndrome

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References


Gleason C, Devaskar S, Avery M. Avery's diseases of the newborn. 9th ed. Philadelphia, PA: Elsevier/Saunders. 2012;1:633.

Poulton EP, Axon DM. Left sides heart failure pulmonary edema: its treatment with the pulmonary plus pressure machine. Lancet. 1936; 231:981-6.

Harrison VC, HdeV H, Klein M. The significance of grunting in hyaline membrane disease. Pediatr 1968; 41:549-59.

Gregory GA, Kitterman JA, Phibbs RH, Tooley W, Hamilton WK. Treatment of idiopathicrespiratory distress syndrome with continuous positive airway pressure. N Engl J Med. 1971;284:1333-40.

Murali MV, Ray D, Paul VK, Deorari AK, Singh M. Continuous positive airway pressure (CPAP) with a face mask in infants with hyaline membrane disease. Ind Pediatr. 1988,25:627-31.

Kishore M, Dutta S, Kumar P. Early nasal intermittent positive pressure ventilation versus continuous positive airway pressure for respiratory distress syndrome. Acta paediatr. 2009;98(9):1412-15.

Ho JJ, Henderson-Smart DJ, Davis PG. Early versus delayed initiation of continuous distending pressure for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev. 2002;(2):CD002975.

Finer NN, Carlo WA, Walsh MC, Rich W, Gantz MG, Laptook AR, et al. Early CPAP versus surfactant in extremely preterm infants. N Eng J medicine. 2010;362(21):1970-79.

Bohlin K. RDS--CPAP or surfactant or both. Acta paediatrica. 2012;101(464):24-8.

Boo NY, Zuraidah AL, Lim NL, Zulfiqar MA. Predictors of failure of nasal continuous positive airway pressure in treatment of preterm infants with respiratory distress syndrome. J Trop Pediatr. 2000; 46:172-5.

Lanieta K, Joseph K, Josaia D, Samantha C, Trevor D. An evaluation of bubble-CPAP in a neonatal unit in a developing country: effective respiratory support that can be applied by nurses. J Trop Pediatr. 2006;52:249-53.

Pieper CH, Smith J, Maree D, Pohl FC. Is nCPAP of value in extreme preterms with no access to neonatal intensive care: J Trop Pediatr. 2003;49:148-52.

Verder H, Robertson B, Greisen G, Ebbesen F, Albertsen P, Lundstrom K, Jacobsen T. Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. N Eng J Medicine. 1994;331(16):1051-5.

Reininger A, Khalak R, Kendig JW, Ryan RM, Stevens TP, Reubens L, et al. Surfactant administration by transient intubation in infants 29 to 35 weeks’ gestation with respiratory distress syndrome decreases the likelihood of later mechanical ventilation: A randomized controlled trial. J Perinatol. 2005;25:703.

Tapia JL, Urzua S, Bancalari A, Meritano J, Torres G, Fabres J, et al. Randomized trial of early bubble continuous positive airway pressure for very low birth weight infants. J Pediatr. 2012;161(1):75-80.

Bassiouny MR, Gupta A, el Bualy M. Nasal continuous positive airway pressure in the treatment of respiratory distress syndrome: an experience from a developing country. J Tropic pediatr. 1994;40(6):341-4.