Bubble-CPAP in Neonatal Unit of TUTH

Abstract

Introduction: Nasal Continuous Positive Airway Pressure (CPAP) in newborn babies with respiratory distress reduces requirement for mechanical ventilation thereby decreasing referral to higher centre. In our neonatal unit prior to the use of this intervention, morbidity and mortality associated with respiratory distress was significant which has decreased after we started CPAP in Kartik 2065 (October 2008) including a decrease in referrals to higher centre for ventilator support.The objective of this study was to evaluate the outcome of bubbling CPAP in newborn babies who had respiratory distress. Methods: Observational study done in neonatal unit of TUTH over a period of 3 months i.e from Kartik to Poush 2065 B.S (mid of October to mid of January,2008) Results: 127 neonates were admitted, of whom 15 babies with respiratory distress (11.8% of total admissions) received CPAP. 11 babies improved, while 4 babies died. Among those attending follow up (8 babies) none had any features of chronic lung disease. Conclusion: In resource poor settings where level II neonatal care is already exists; CPAP can be easily applied for newborn babies with respiratory distress with promising results and it helps to decrease neonatal morbidity and mortality. Key words: CPAP, neonatal mortality, respitatory Distress. DOI: 10.3126/jnps.v30i1.2465 Journal of Nepal Paediatric Society Vol.30(1) 2010 64-68

Bubble CPAP to support preterm infants in rural Rwanda: a retrospective cohort study

“…We were unable to accurately assess the severity of respiratory distress among those who were eligible but not initiated on CPAP; however, we suspect that they were likely to be less severely ill. In addition, our study was conducted in rural hospitals without full-time pediatric specialists on staff; however, similarly high mortality rates among bCPAP initiated infants have been reported in studies conducted in teaching hospitals with more specialized staff [ 15 – 17 , 21 ].…”

Mortality and Morbidity Pattern of Preterm Babies at a Tertiary Level Hospital in Nepal

“…Thirty percent of premature babies were put on Bubble-CPAP, among which 71% improved. This improvement can be attributed to the use of Bubble-CPAP, which was started in this centre from October 2008 14 .…”

Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review

“…Several studies addressed secondary outcomes (reduction in need for mechanical ventilation via an endotracheal tube,37–39 and safety and efficacy of bubble CPAP compared with ventilator-driven CPAP35 40 41), while the largest number were case-series describing practical experience with CPAP, both bubble-based or via other systems 31 32 34 42–48. All studies described the use of CPAP in hospitals, with no studies describing home CPAP.…”

“…Among 571 neonates treated with CPAP of any kind with the potential for mechanical ventilation access (either in the same hospital or via transfer to nearby referral hospitals), the mortality rate was 83/571 (14.5%) 31 32 34 42–44 46–48. Of the 343 neonates for whom CPAP failure data are available, 110 (32.1%) failed CPAP therapy and required mechanical ventilation 31 32 34 42 43 47. Due to small numbers, it was difficult to determine the effect of birth weight on failure rate and mortality.…”

“…Due to small numbers, it was difficult to determine the effect of birth weight on failure rate and mortality. Only 3 of 155 infants with reliable data (1.9%) sustained pneumothoraces 32 34 42 43…”