To study the effectiveness of indigenous bubble CPAP in management of respiratory distress in newborns

Dr Hemant Jain,Dr Suresh Menon,Dr Rashika Mandloi,Dr Sunil Arya

doi:10.17511/ijpr.2016.i05.04

Abstract

Background: CPAP has become a useful in management of respiratory distress, especially in preterms. CPAP delivers a continuous distending pressure via the neonates pharynx to the upper and lower airways. The main indication for use of CPAP is RDS. Aim of study: To study the effectiveness of indigenous bubble CPAP in management of respiratory distress in newborn and to determine its outcome. Setting: Department of Pediatrics, MGM Medical College and MY Hospital, Indore during the period February-July 2005. Design: Prospective Observational Study. Method: This study was carried out on inborn neonates in the NICU of MY Hospital over a period of six months. Matched controls were taken from admissions during previous four months. It included the newborns developing respiratory distress with grunting and chest retractions within 6 hours of birth whose severity was measured by Silverman Anderson Score and oxygen saturation.Neonates with increasing Silverman Anderson Score or Oxygen saturation falling below 85%were taken on CPAP and their outcome studied. Result: There were 42 RDS cases in the study group of which 28 survived and 14 died. Indigenous BUBBLE CPAP was beneficial in managing babies with RDS. Conclusion: Indigenous BUBBLE CPAP is an effective and non-invasive way to provide ventilation in a setup with limited resources. It can be used to manage respiratory distress due to RDS, congenital pneumonia & MAS. It resulted in significant reduction in mortality but prognosis was bad in those who required CPAP >8 cm H2O.

Highlights

Continuous positive airway pressure (CPAP) is anon invasive method for applying a constant distending pressure level during inhalation and exhalation to support spontaneously breathing newborns with lung disease [1]
C) Increasing Silverman Anderson Score were taken on CPAP and their outcome studied
The results were compared with the babies with respiratory distress, who were managed in the same setting in the preceding 4 months without CPAP

Summary

Introduction

Continuous positive airway pressure (CPAP) is anon invasive method for applying a constant distending pressure level during inhalation and exhalation to support spontaneously breathing newborns with lung disease [1]. The main indication for use of CPAP is respiratory distress syndrome. Lack of awareness and suboptimal practice of antenatal steroids result in frequent RDS in premature babies. Use of CPAP will be low-cost, simple and noninvasive option for a country like India, where most places cannot provide invasive ventilation. With the cost of surfactant likely to decrease markedly, use of early CPAP in conjunction with surfactant, when indicated can prove to be a boon in future for preterm in India. The present study was undertaken to determine the effectiveness of indigenous. Manuscript received: 14th March 2016 Reviewed: 27th March 2016 Author Corrected; 10th April 2016 Accepted for Publication: 23rd April 2016

Method

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Discussion