SAFETY AND EFFECTIVENESS OF BUBBLE CONTINUOUS POSITIVE AIRWAY PRESSURE IN NEONATES WITH RESPI-RATORY DISTRESS AND ITS FAILURE FACTORS

Abstract

Background: Studies on Bubble Continuous Positive Airway Pressure (B-CPAP) as respiratory support for neonates are few. The aim of our study was to determine the efficacy and safety of B-CPAP in preterm and term neonates requiring respiratory support and to study its failure factors, so we can come out of it and utilize this non-invasive cost effective method widely and successfully.

Methods: A prospective observational study was done on 51babies both term and preterm babies admitted in NICU of SMIMER Hospital, Surat, requiring respiratory support for mild to moderate respiratory distress. Support was given with short nasal prongs with under water seal Bubble C Pap. Surfactant was administered when indicated. Monitoring was done clinically, with pulse oximeter, radiologically and with blood gases.

Result: The mean gestational age of the study population was 32-34 weeks and birth weight was 1.501 g. 53% of the population were Very Low Birth Weight (VLBW) babies weighing less than 1500 g. C-PAP failure rate was higher in these babies. The most common disease for starting B-CPAP was RDS (80%) followed by pneumonia (17%), TTNB (0%) and MAS (2%). The commonest complications on B-CPAP were shock, apnea and nasal damage. Overall failure of BCPAP occurred in 21/51 cases or 40%. All babies who failed BCPAP were put on mechanical ventilation. Failures in RDS group were 18/41 or 43%. Failure rate in the pneumonia group was 3/9 or 33.3%. Higher cases of sepsis and pulmonary haemorrhage were seen in failure group (table2).Overall survival rate of the study population was 60 %.

Conclusion: Bubble Continuous Positive Airway Pressure is safe, efficacious and easy to use in preterm& term neonates with mild to moderate respiratory distress. The major failure factors in our study were sepsis, recurrent apnea, and shock. The survival rate in our study was 60%.