ROLE OF BUBBLE CONTINUOUS POSITIVE AIRWAY PRESSURE AND ITS EFFICACY IN MANAGEMENT OF NEONATES WITH RESPIRATORY DISTRESS IN A TERTIARY CARE HOSPITAL

DR BALAKA SURESH KUMAR; DR GORRIPATI KALYAN CHAKRAVARTHY

Volume : VIII, Issue : I, January - 2019

ROLE OF BUBBLE CONTINUOUS POSITIVE AIRWAY PRESSURE AND ITS EFFICACY IN MANAGEMENT OF NEONATES WITH RESPIRATORY DISTRESS IN A TERTIARY CARE HOSPITAL

Dr Balaka Suresh Kumar, Dr Gorripati Kalyan Chakravarthy

Abstract :

INTRODUCTION: Respiratory distress is the most important cause of morbidity and mortality in neonatal period. The most common causes of respiratory distress in newborn are respiratory distress syndrome, apnea of prematurity, transient tachypnea of newborn, meconium aspiration syndrome and sepsis. AIMS & OBJECTIVES: This study is done to find out effectiveness of bubble CPAP in neonates with respiratory distress and also to find out CPAP failure rates . To observe survival of newborn neonates with respiratory distress treated with bubble CPAP in tertiary care Centre. MATERIAL & METHODS: Prospective study was done from July/2018 to November/2018 on 54(n) newborn babies requiring respiratory support for mild to moderate respiratory distress according to silveraman scoring. Support was given with bubble CPAP in combination with surfactant whenever required via INSURE (intubation, surfactant,extubation) protocol. RESULTS: Out of 54(n) neonates studied, 73.3% (n=39) were preterm babies and 27.7%(n=15) were term babies requiring respiratory support in the form of bubble CPAP. Most common cause of respiratory distress in preterm babies is RDS (41%), Apnea of prematurity in the second order with 23% of cases in our study. In term babies both TTN & MAS (meconium aspiration syndrome) comprising of 33.33% were common causes. Bubble CPAP failure rate was seen in 14.8% of cases out of which 87.5%cases were preterm neonates .Main complications were skin aasions (51.8%), feed intolerance (37%), secondary infection(31.4%).survival rate was 96.2%. CONCLUSION: Bubble continuous positive pressure (CPAP) is safe, efficacious and easy to use in both term and preterm babies with mild to moderate respiratory distress. CPAP Failure is significantly associated with babies who did not receive antenatal steroids, presence of significant sepsis and silveraman score more than 7 at admission.