A Two Year Experience in Continuous Positive Airway Pressure Ventilation Using Nasal Prongs and Pulse Oximetry

Abstract

In a prospective study 26 of the 116 consecutive neonates suffering from respiratory distress survived on varying concentrations of humidified oxygen. Continuous positive airway pressure (CPAP) of 4-12 cm of water was applied through short nasal prongs to 90 neonates. Haemoglobin oxygen saturation (SaO2) rose in all and it was maintained steadily above 85% in 46 (51%) infants who survived. The mean duration of CPAP among the survivors was 61 hours (range 8-190 hours). Common indications of CPAP ventilation were hyaline membrane disease (HMD) (27.7%), meconium aspiration syndrome (MAS) (20%), apnea of prematurity (18.8%) and asphyxia (17.7%). Neonates weighing >1000 gm faired well with overall survival of 60 to 82.35%. However, among the 16 babies weighing <1000 gm, only 3 (18.75%) survived. 4 infants on CPAP died due to pneumothorax, none had complications of oxygen toxicity. The 44 CPAP failures, fared poorly even when shifted to intermittent positive pressure ventilation (IPPV) regardless of their weight and 1 among the 5 survivors developed grade 1 intraventricular haemorrhage. It was concluded that nasal CPAP ventilation with pulse oximetry is a simple and efficient method of treating respiratory distress in newborns. This technique can be adopted even by smaller hospitals where the equipment and expertise for IPPV and arterial blood gas (ABG) monitoring are not feasible.

Use of Bubble Continuous Positive Airway Pressure (BCPAP) in Management of Neonatal Respiratory Distress Syndrome in Resource Limited Settings

“…Various studies have detailed the fact that rapid raise in oxygen saturation was seen in usage of bCPAP with improvement in lung function and decreases of RDS symptoms in new born. [15][16][17][18][19] as also presented in the current study results where the success rate by using bCPAP was observed up to 76.2%.…”

Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

“…1,2 Respiratory distress is one of the most common diseases that affect these premature infants, and they most often require respiratory support through the use of mechanical ventilation (MV). 3,4 Medical conduct from the respiratory perspective has been directed to minimize the need for prolonged MV through respiratory assistance where aggression and time are kept as low as possible in order to reduce barotrauma and oxygen toxicity. 5,6 High morbidity occurs even with the use of surfactant, especially in premature infants requiring MV for a prolonged period.…”

Improvised bubble continuous positive airway pressure (BCPAP) device at the National Hospital Abuja gives immediate improvement in respiratory rate and oxygenation in neonates with respiratory distress

“…The outcome in these babies from their study was significantly better than those in whom there was a delay (1 hour) in commencing CPAP. The usefulness of pulse oximetry as a monitoring tool for babies on CPAP was noted by Malik et al 17 who reported a rapid rise in SPO 2 to >85% and this was sustained among survivors. This pattern of response is similar to the findings in our study.…”