Success of bubble continuous positive airway pressure in preterm neonates admitted with respiratory distress syndrome at tertiary care center

Abstract

Background: Application of continuous positive airway pressure (CPAP) in neonate with respiratory distress is associated with reduction of respiratory failure, complications, and mortality. Bubble CPAP (B-CPAP) is a most popular CPAP mode, but studies on B-CPAP as respiratory support for neonates are few. Therefore, the present study was conducted to assess the effectiveness of B-CPAP on immediate outcome of preterm infants of gestational age 28–36 weeks with respiratory distress syndrome (RDS) and to identify the risk factors associated with its failure. Materials and Methods: This longitudinal study was conducted in neonates admitted in the newborn unit with respiratory distress with Downe's score 4–6, SPO2 < 85% even with supplemental oxygen during a period from August 1, 2019 to July 31, 2020. Investigations to diagnose the cause of respiratory distress were done including radiograph of the chest in all cases. Results: Out of total 330 neonates, 245 babies weaned from CPAP ventilation and discharged while 85 babies succumbed to the illness. Mortality was high in male babies, weighing <1.5 kg and babies with septicemia. At day 0 of administration of B-CPAP, 25.75% had Downes score 4, 33.03% were in score 5, and 41.21% were in score 6. All parameters such as cyanosis, grunting, tachypnea, chest indrawing, and air entry improved with B-CPAP administration. The various causes of respiratory distress were asphyxia, RDS, apnea of prematurity, meconium aspiration syndrome (MAS), and bronchopneumonia sepsis. Out of this, 22 babies with RDS and all babies with MAS and sepsis had significant radiological findings. Conclusion: We concluded that, this form of therapy should be adopted even by the smaller hospitals to improve the survival of neonates with respiratory distress.