Failure Factors of Bubble CPAP in Neonates with Respiratory Distress

Abstract

Background: Respiratory distress is the most frequent presenting complaint of newborn encountered within the first 48–72 hours of life. An infant who is breathing on instinct is given non-invasive respiratory support called Bubble Continuous Positive Airway Pressure (Bubble CPAP) to help them to maintain a long volume during expiration. The study aimed to identify failure factors of Bubble CPAP in neonate with respiratory distress. Material & Methods: From April to September 2017, a cross-sectional study was carried out at the Department of Neonatal Medicine in Bangladesh Shishu Hospital & Institute. One hundred and eight (N=108) newborns with respiratory distress who were given Bubble CPAP were enrolled for the study. After receiving the parent’s or guardian’s written informed consent, all the necessary information were recorded in a predesigned proforma that included the patient’s specifics. Then completed data forms were reviewed, updated, and prepared for computer data input. The “t” test, “r” test and Statistical Package for the Social Sciences (SPSS) Version 23.0 were used to analyze the data. Results: Among study patients (N=108), most of the neonates 49 (45.4%) belonged to age ≤24 hours and the neonates with respiratory distress which needed Bubble CPAP support 18 (16.7%) had RDS, 18 (16.7%) had PNA, 15(13.9%) had pneumonia, 14(13.0%) had PPHN, and 10(9.3%) had sepsis. More than three-fourths of the patients (85) were found successfully weaned and one-fifth of the patients (23) failed. Conclusion: The most frequent causes of respiratory distress were RDS, PNA, PPHN, Sepsis, congenital pneumonia, and pneumonia. Grunting respiration, higher RR, lower SPO2, higher FiO2 and cyanosis were substantially associated with Bubble CPAP failure among the respiratory distress symptoms. PPHN and sepsis have a causal relationship with Bubble CPAP failure. More duration of Bubble CPAP and more hospital stay also have relation with Bubble CPAP failure. The majority of patients were weaned, however, patients who failed Bubble CPAP died more frequently.