Abstract
Background: Respiratory distress syndrome (RDS) is an important cause of mortality and morbidity in preterm infants. An effective way to reduce the incidence of chronic lung injury is to use continuous positive airway pressure (CPAP) and avoid mechanical ventilation. Objective: To assess the effectiveness of bubble CPAP (BCPAP) on immediate outcome of preterm infants with mild to moderate RDS in a level 2 neonatal intensive care unit (NICU) in Bangalore, India. Method: A prospective analytical study was carried out on preterm neonates of gestational age 28 to 36 weeks with mild to moderate RDS admitted to a level 2 NICU in Bangalore, India, from November 2011 to May 2013. Downe score (DS) was used to assess the severity of RDS. Effectiveness of CPAP was judged using DS and fraction of inspired oxygen (FiO2) requirement. Results : BCPAP was effective in 91% of the studied babies. At the start of CPAP 11%, 48% and 41% of babies had DS of 4, 5 and 6 respectively. At 6 hours of CPAP therapy, 56% of the babies had a score of less than 4. At 12 hours of CPAP therapy 89% of babies had a score of 4 or less, only 3% and 8% of the babies having DS of 5 and 6 respectively. Nine percent of the babies persisted in having a FiO2 requirement of 50% or more at 6 and 12 hours of CPAP therapy. Conclusion: BCPAP was effective in 91% of the studied preterm neonates of gestational age 28 to 36 weeks with mild to moderate RDS in a level 2 NICU in Bangalore, India. Sri Lanka Journal of Child Health , 2017; 46 : 211-217
Highlights
Respiratory distress syndrome (RDS) is an important cause of mortality and morbidity in preterm infants
Bubble CPAP (BCPAP) was effective in 91% of the studied babies
Nine percent of the babies persisted in having a FiO2 requirement of 50% or more at 6 and 12 hours of continuous positive airway pressure (CPAP) therapy. 1Subbaiah Institute of Medical Sciences, India, 2Bangalore Medical College & Research Institute, Bangalore, India *Correspondence: drhyalyads@gmail.com (Received on 14 September 2016: Accepted after revision on 21 October 2016) The authors declare that there are no conflicts of interest Personal funding was used for the project
Summary
Respiratory distress syndrome (RDS) is an important cause of mortality and morbidity in preterm infants. An effective way to reduce the incidence of chronic lung injury is the use of continuous positive airway pressure (CPAP) and avoidance of mechanical ventilation[1,3]. Bubble CPAP (BCPAP) prevents alveolar collapse, ensures gas exchange throughout the respiratory cycle and allows lung inflation to be maintained. It can be effectively given through the silastic nasal tubes or nasal prongs which eliminate the need for the endotracheal intubation[4]. Not all preterm infants with RDS respond to BCPAP and not all preterm infants with RDS are candidates for initial treatment with CPAP4,6
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