Archive | 2019
Outcome of Bubble (CPAP) Continuous Positive Airway Pressure in Neonates with Respiratory Distress and its failure factors.
Abstract
Introduction: Bubble CPAP is an important, simple, noninvasive, and cost effective treatment modality for respiratory distress in neonates. The aim of our study was to know the outcome of Bubble CPAP in preterm and term neonates requiring respiratory support and to study its failure factors. Material and methods: A retrospective observational study with Bubble CPAP was done on 100 babies both term and preterm with respiratory distress requiring for respiratory support admitted in NICU of Government General Hospital, Guntur. Monitoring was done clinically, with pulse oximeter, radiologically and with blood gases. Neonates with respiratory distress secondary to sepsis, necrotizing entero colitis, congenital anomalies like Tetrology of Fallot, cleft lip with cleft palate, congenital diaphragmatic hernia, choanal atresia, who had severe respiratory distress with cardio vascular instability were excluded in our study. Results: The mean gestational age was 32-34 weeks, birth weight was 1.4 kgs.52% were very low birth weight<1.5 kgs. CPAP failure rate was higher in preterm and very low birth weight. The most common disease for starting Bubble CPAP was Respiratory Distress Syndrome 56 cases followed by Meconium Aspiration Syndrome 16 cases, congenital pneumonia, Transient Tachypnea of New Born and Birth Asphyxia. The common complications on CPAP were shock, apnea and nasal damage. Overall failure rate was 36% (36 cases). All babies who failed on CPAP were put on mechanical ventilation. Failure among Respiratory Distress Syndrome was about 42%, in Meconium Aspiration Syndrome 31%, congenital pneumonia 35.7%. Higher cases of sepsis and pulmonary hemorrhage were seen in failure group. Overall survival rate of the study was 64%(64cases). Conclusion: Bubble Continuous Positive Airway Pressure is safe, effective and easy to use in preterm and term neonates with mild to moderate Respiratory Distress. The major failure factors in our study were sepsis, recurrent apnea. The success rate was 64%.