Study of Efficacy and Outcome of Nasal Cpap in Preterm Neonates with Hyaline Membrane Disease

Abstract

Background: In the quest to bring down the neonatal mortality rate, the challenge is to develop low cost technology thatcan be used in remote settings. It is known that early use of continuous positive airway pressure (CPAP) reduces theincidence of respiratory distress and it may be used as an alternative to intubation and ventilation is some casesObjectives: To study the efficacy and outcome of Nasal CPAP in preterm neonates with Hyaline membrane disease.Methods: 50 preterm newborns with respiratory distress (Silverman"s score 3-6) admitted in NICU were included in thestudy. All study population were connected to CPAP variables like gestational age, birth weight, antenatal steroids,Downes Score, Age of start of CPAP, initial FiO2, initial PEEP , max FiO2, max PEEP, duration of CPAP, duration of O2administration, acute complications like sepsis, pneumothorax, septal damage and duration of hospital stay are comparedbetween CPAP success and CPAP failure groups.Results: Preterm New-borns between 31-34 wks of gestational age had a success of 96.5% as compared to gestationalage of 28-30 wks had success of 76.1% and p value 0.02. Preterm New-borns with birth weight > 1000 gms had success of89% when compared to <1000gms had success rate of 50% which is statistically significant. Preterms New-borns born tomothers who received antenatal steroids had better outcome (CPAP success rate of (87.7%) as compared to babies born tomothers who had not received antenatal steroidsConclusion: Early use of bubble CPAP is associated with lesser need for mechanical ventilation as well as reducedhospital stay. Bubble CPAP in pre-term neonates is efficient in decreasing respiratory distress, and associated with lessercomplications as well as mortality rate.