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 that
can be used in remote settings. It is known that early use of continuous positive airway pressure (CPAP) reduces the
incidence of respiratory distress and it may be used as an alternative to intubation and ventilation is some cases
Objectives: 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 the
study. 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 O2
administration, acute complications like sepsis, pneumothorax, septal damage and duration of hospital stay are compared
between 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 gestational
age of 28-30 wks had success of 76.1% and p value 0.02. Preterm New-borns with birth weight > 1000 gms had success of
89% when compared to <1000gms had success rate of 50% which is statistically significant. Preterms New-borns born to
mothers who received antenatal steroids had better outcome (CPAP success rate of (87.7%) as compared to babies born to
mothers who had not received antenatal steroids
Conclusion: Early use of bubble CPAP is associated with lesser need for mechanical ventilation as well as reduced
hospital stay. Bubble CPAP in pre-term neonates is efficient in decreasing respiratory distress, and associated with lesser
complications as well as mortality rate.