Use of Bubble CPAP in Preterm Neonates with Respiratory Distress at a Tertiary Care Hospital

Abstract

Objective: To determine the outcome of Bubble Continuous Positive Airway Pressure (bCPAP) Therapy use in preterm neonates with respiratory distress admitted in large public sector children hospital. Methods: This prospective observational study was conducted at National Institute of Child Health (NICH) from March 2016 to February 2017. All preterm neonates with respiratory distress diagnosed within 24 hours treated with bCPAP were consecutively included. Respiratory distress was defined on the basis of presence of any of the three following symptoms (i) tachypnea (ii) chest indrawing (iii) grunting (iv) nasal flaring (v) hypoxemia. Outcome was measured in terms of survival, median for duration to achieve 21% O , apnea, hyperemia of nose, 2 abdominal distention, median for hospital stay, and median weight gain. Results: Of 70 preterm neonates, the median birth weight was 2700 (2300 - 3000) gm, duration to achieve 21% O2 was 3 (2 - 72) hours, and hospital stay was 8 (6-10) days. The complications of bubble CPAP showed that abdominal distension was found higher followed by hyperemia of nose and apnea i.e., 18 (25.7%), 17 (24.3%), and 4 (5.7%) respectively. Survival was found significantly associated with birth weight (p-value 0.049) and in neonates with no complications (p-value <0.001). Whereas apnea was found significantly higher in female preterm neonates (p-value 0.017), low birth weight (p-value 0.012) and in neonate who reported no survival (p-value <0.001). Conclusion: The administration of bCPAP is an effective modality for managing respiratory illness in preterm Neonates due to fewer complications and shorter hospital stay.