Bubble CPAP: Evaluation of complications

Abstract

Bubble CPAP creates chest wall vibrations and improves the respiratory outcomes of the neonate. The Positive End Expiratory Pressure is established by the expiratory limb under water. Bougatef (NICU UZ Brussels) recommends a maximum PEEP of 7 cm H 2 O with a constant airflow at the rate of 7 l/min. Since the introduction of the Bubble CPAP system with binasal prongs (Fisher and Paykel Healthcare), more nasal injuries were observed. A quantitative describing study with a longitudinal design was conducted to evaluate the complications of using BCPAP. 17 neonates (group 1 = 9 neonates < 1000 g; group 2 = 4 neonates < 2000 g; and group 3 = 4 neonates > 2000 g) were included into this study between 1st December 2008 and 15th March 2009. The evaluation sheet, containing all key points of using BCPAP, was filled in every 6 h by the neonatal nurse. All data were imported in Access ® and analysed in Excel ® . 15 of 17 neonates showed after one day a slightly nasal septum irritation. Redness of the nasal septum was mostly seen in the first two groups after 3 days and dark discoloration was only observed in 2 neonates of the first group. None of these neonates had a pneumothorax or a Belly syndrome. A nursing care plan and methods to improve BCPAP successfully can prevent complications. Nasal injuries must be immediately treated and BCPAP therapy must be discontinued as early as possible.