Bubble CPAP Therapy in Newborns With Respiratory Distress With Its Outcome-A Prospective Observational Study From a Neonatal Intensive Care Unit of Tertiary Care Hospital in Western Nepal.
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引用次数: 0
Abstract
Background: Respiratory distress is one of the most common reasons for the admission of neonates to the NICU in low and middle-income countries (LMICs) like Nepal, where bubble CPAP therapy is one of the most emerging and first-line treatments.
Aims: The aim is to study the various indications of bubble CPAP therapy in neonates with respiratory distress in different clinical conditions, success and failure rates, and outcomes.
Methods: A prospective observational study was conducted for 17 months (Oct 2021-Feb 2023) at Universal College of Medical Sciences, Bhairahawa, Nepal, where 90 neonates with respiratory distress were enrolled and kept on bubble CPAP therapy. Various clinical conditions of CPAP use were observed along with success and failure rates. The final outcome was documented as discharge or death occurred.
Results: A total of 90 babies with respiratory distress required CPAP therapy, where 53.3% were preterm, 44.4% term, and the rest postterm. About 32.2% of neonates had birth asphyxia, 16.7% had respiratory distress syndrome (RDS), 14.4% of cases had prematurity, and 12.2% had meconium aspiration syndrome. The study found a significant mean difference in Silverman score (in preterms) and Downe's score (in terms) before and after 6 h of CPAP (p < 0.001 in each) and 12 h of life (p < 0.001 in each). Out of the total enrolled babies, 67 (74.4%) neonates survived whereas 25.6% had mortality. The present study showed CPAP success and failure rates of 68.9% and 31.1%, respectively. Out of total CPAP failure rate (n = 28) babies, 67.9% had mortality and 32.1% were successfully discharged. No significant association of CPAP failure was seen when compared to gender, religion, gestational age, mode of delivery, resuscitation received, various indications of CPAP use, use of antenatal steroid, and duration of initiation of CPAP.
Conclusion: Birth asphyxia, respiratory distress, and prematurity were three leading causes of respiratory distress for the initiation of CPAP in the present study.
背景：在尼泊尔等中低收入国家（LMICs），呼吸窘迫是新生儿入住NICU最常见的原因之一，在这些国家，气泡CPAP治疗是最新兴的一线治疗方法之一。目的：探讨不同临床条件下泡式CPAP治疗新生儿呼吸窘迫的适应症、成功率、失败率及预后。方法：在尼泊尔Bhairahawa的Universal College of Medical Sciences进行了一项为期17个月（2021年10月- 2023年2月）的前瞻性观察研究，其中90名呼吸窘迫的新生儿入组并持续进行气泡CPAP治疗。观察CPAP使用的各种临床情况以及成功率和失败率。最终结果记录为出院或死亡。结果：共有90例呼吸窘迫患儿需要CPAP治疗，其中早产患儿占53.3%，足月患儿占44.4%，其余为足月患儿。新生儿窒息占32.2%，呼吸窘迫综合征（RDS）占16.7%，早产占14.4%，胎粪吸入综合征占12.2%。研究发现，CPAP治疗前后6小时（p < 0.001）和12小时（p < 0.001）的西尔弗曼评分（早产儿）和唐氏评分（术语）的平均差异具有统计学意义。在所有登记的婴儿中，67名（74.4%）新生儿存活，而25.6%的新生儿死亡。本研究显示CPAP的成功率和失败率分别为68.9%和31.1%。在总CPAP失败率（n = 28）例婴儿中，67.9%的婴儿死亡，32.1%的婴儿成功出院。与性别、宗教、胎龄、分娩方式、接受的复苏、使用CPAP的各种适应症、产前类固醇的使用和启动CPAP的持续时间相比，CPAP失败没有明显的相关性。结论：出生窒息、呼吸窘迫和早产是本研究中启动CPAP呼吸窘迫的三个主要原因。
期刊介绍：
International Journal of Pediatrics is a peer-reviewed, open access journal that publishes original researcharticles, review articles, and clinical studies in all areas of pediatric research. The journal accepts submissions presented as an original article, short communication, case report, review article, systematic review, or letter to the editor.
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