Analytical Study of Different Modes of Continuous Positive Airway Pressure (CPAP) in Management of Respiratory Distress Syndrome (RDS) Preterm Neonates

Abstract

Background: Respiratory distress syndrome (RDS), is the single most important cause of morbidity and mortality in preterm infants. In infants with progressive respiratory insufficiency, intermittent positive pressure ventilation (IPPV) with surfactant has been the usual treatment, but it is invasive, potentially resulting in airway and lung injury. Continuous positive airway pressure (CPAP) has been used for the prevention and treatment of respiratory distress syndrome, as well as for the prevention of apnoea, and in weaning from IPPV. Objective: To evaluate the effect of different types of CPAP in treatment of preterm neonates with respiratory distress syndrome in Al-Azhar (Assiut) university hospital neonatal intensive care unit (NICU). Patients and methods: This was a prospective study, conducted at Al-Azhar (Assiut) university hospital NICU. The study included 60 preterm neonates with respiratory distress syndrome divided into 3 groups: (1 st group); 20 cases on nasal CPAP; (2 nd group); 20 cases on nasopharyngeal CPAP and (3 rd group); 20 cases on mask CPAP from March 2021 to November 2021. Results:The results of our study showed significant difference between the three groups regarding complications, nasal irritation and problems in fixation as it occur in (10%, 10%, 85%) respectively of cases in mask group and (90%, 85%, 85%) respectively in nasal group and (90%, 0%,0%) respectively in nasopharyngeal group with p value < 0.001 in all. There was also a significant difference between the three groups regarding to response to treatment with P value < 0.04.Conclusions: CPAP is one of the effective treatments of RDS leading to significant improvement of outcome, reducing hospital stay and the need for invasive mechanical ventilation with its harmful adverse effects and thus the case fatality rate of RDS cases and so the overall mortality rate of the NICU.