A Clinical Study on Role of Bubble CPAP in Respiratory Distress Syndrome in Preterm Neonates
Creators
- 1. Resident Doctor, Department of Paediatrics, Jawaharlal Nehru Medical College, Ajmer
- 2. Senior Professor, Department of Paediatrics, Jawaharlal Nehru Medical College, Ajmer
- 3. Associate Professor, Department of Paediatrics, Jawaharlal Nehru Medical College, Ajmer
- 4. Resident doctor, Department of Paediatrics, Jawaharlal Nehru Medical college, Ajmer
Description
Background: Non- invasive ventilation like continuous positive airway pressure (CPAP) in spontaneously breathing neonates with respiratory distress improves survival and also reduces the incidence of chronic lung disease in newborns. The aim of our study was to study the effectiveness of CPAP in Respiratory Distress Syndrome (RDS) in preterm newborns in different weight and gestational groups. Materials And Methods: This cross- sectional descriptive study was performed in the NICU of JANANA (part of JLN hospital Ajmer) and JLN hospital Ajmer itself, tertiary care centres in Ajmer, Rajasthan on 140preterm neonates admitted immediately or within 24 hours after birth with Silverman Anderson Score 4-7 with Respiratory distress syndrome. Results: Total 140 preterm neonates with RDS recruited in our study. Among them 71 (50.71%) were males and 69 (49.29%) were females.Overall success rate of B-CPAP was noted to be 72.85%. Good recovery was seen among babies with birth weight of 2-2.5 kg and >2.5 kg i.e 100%. There was a significant difference in outcome of bubble CPAP between birth weight <1000gm(51%) and birth weight ≥1000 gm(83%). (p=0.0011). Most infants with gestational age <28 weeks had B-CPAP failure (60%). Gestational age 28-29weeks also had higher number of CPAP failure as compared to gestational age 30- 31 (17.88%), 32 to 34 weeks (12%) and ≥35 weeks of gestation which was lowest around 0% (p-0.0003). Outcome of cases of RDS was also affected by initial respiratory severity score – SAS. Higher percentage of CPAP success was seen with initial scores 4(78.9%) and 5(84.75%) as compared to higher scores 6(59.26%) and 7 (62.5%) [p value – 0.018]Sepsis was seen as the commonest morbidity in this study cohort. Overall, 49 out of 140 cases (35%) had sepsis. Sepsis was seen in larger percentage of cases in failure group. 27 out of 38 failed cases had sepsis (71%) while only 28 cases out of 102 (21%) in recovered group had sepsis but its value as a predictor of CPAP failure could not be proven. Birth weight <1000gm, gestational age <30 weeks and initial SAS score ≥ 6 proved to be significant predictors of CPAP failure. Conclusion: Bubble continuous positive airway pressure is a safe and effective mode of respiratory support in preterm neonates with respiratory distress syndrome.
Abstract (English)
Background: Non- invasive ventilation like continuous positive airway pressure (CPAP) in spontaneously breathing neonates with respiratory distress improves survival and also reduces the incidence of chronic lung disease in newborns. The aim of our study was to study the effectiveness of CPAP in Respiratory Distress Syndrome (RDS) in preterm newborns in different weight and gestational groups. Materials And Methods: This cross- sectional descriptive study was performed in the NICU of JANANA (part of JLN hospital Ajmer) and JLN hospital Ajmer itself, tertiary care centres in Ajmer, Rajasthan on 140preterm neonates admitted immediately or within 24 hours after birth with Silverman Anderson Score 4-7 with Respiratory distress syndrome. Results: Total 140 preterm neonates with RDS recruited in our study. Among them 71 (50.71%) were males and 69 (49.29%) were females.Overall success rate of B-CPAP was noted to be 72.85%. Good recovery was seen among babies with birth weight of 2-2.5 kg and >2.5 kg i.e 100%. There was a significant difference in outcome of bubble CPAP between birth weight <1000gm(51%) and birth weight ≥1000 gm(83%). (p=0.0011). Most infants with gestational age <28 weeks had B-CPAP failure (60%). Gestational age 28-29weeks also had higher number of CPAP failure as compared to gestational age 30- 31 (17.88%), 32 to 34 weeks (12%) and ≥35 weeks of gestation which was lowest around 0% (p-0.0003). Outcome of cases of RDS was also affected by initial respiratory severity score – SAS. Higher percentage of CPAP success was seen with initial scores 4(78.9%) and 5(84.75%) as compared to higher scores 6(59.26%) and 7 (62.5%) [p value – 0.018]Sepsis was seen as the commonest morbidity in this study cohort. Overall, 49 out of 140 cases (35%) had sepsis. Sepsis was seen in larger percentage of cases in failure group. 27 out of 38 failed cases had sepsis (71%) while only 28 cases out of 102 (21%) in recovered group had sepsis but its value as a predictor of CPAP failure could not be proven. Birth weight <1000gm, gestational age <30 weeks and initial SAS score ≥ 6 proved to be significant predictors of CPAP failure. Conclusion: Bubble continuous positive airway pressure is a safe and effective mode of respiratory support in preterm neonates with respiratory distress syndrome.
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IJPCR,Vol15,Issue6,Article132.pdf
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Additional details
Dates
- Accepted
-
2023-06-20
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue6,Article132.pdf
- Development Status
- Active
References
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