Use of CPAP in Premature Babies

Abstract

Respiratory distress syndrome (RDS) is the most common respiratory disorder of preterm infants and is a major course of neonatal mortality and morbidity. The combined use of antenatal steroids and early continuous positive airway pressure (CPAP) are considered the gold standard for the prevention and treatment of RDS in the preterm infant. CPAP used in the spontaneous breathing neonate maintains adequate functional residual capacity within the alveoli to prevent atelectasis and support gas exchange CPAP is most commonly delivered using bi-nasal short prongs or a nasal mask. Pressure is generated using a variety of devices. CPAP is generally well tolerated, in part because infants are preferential or "obliga-tory nasal breathers". CPAP has revolutionised the outcome in premature babies by reducing the need for mechanical ventilation and the use of surfactant. Prophylactic or early CPAP in the delivery room reduces the need for surfactant and mechanical ventilation by nearly 50%. CPAP is an attractive option for supporting neonates with respiratory distress, because it preserves spontaneous breathing, does not require endotracheal intubation, and may result in less lung injury than mechanical ventilation.