scholarly journals Bubble CPAP (Continuous Positive airway pressure) therapy as a primary mode of respiratory support in preterm newborns with mild to moderate respiratory distress syndrome

2021 ◽  
Vol 8 (2) ◽  
pp. 94-99
Author(s):  
Dr. Sanjivani Deepak Maslekar ◽  
◽  
Dr. Somaiah G ◽  
Dr. Nagapraveen Veerapu ◽  
◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Respiratory Support ◽  
Pressure Therapy ◽  
Primary Mode ◽  
Antenatal Steroids ◽  
Bubble Cpap ◽  
Preterm Newborns

Background: Respiratory distress syndrome (RDS) is an important cause of morbidity and mortalityin preterm infants. Bubble CPAP when used appropriately, is more cost-effective, non-invasive,requires less training and has a lower risk of complications. However, not all preterm infants withRDS respond to CPAP. Aims: To study the immediate outcome of preterm infants with mild tomoderate respiratory distress syndrome on Bubble CPAP. To study the safety and effectiveness of B-CPAP and to identify the risk factors associated with its failure. Setting: NICU, Department ofpediatrics, Mamata general hospital and medical college, Khammam. Design- Prospectiveobservational study Material and Methods: This duration bound study was conducted fromFebruary 2018 to February 2020. Based on the inclusion criteria 73 Preterm babies with mild tomoderate respiratory distress syndrome requiring respiratory support were included in this study.Details of birth history, use of antenatal steroids, gestational age, type of delivery, birth weight,Downes score and chest X-ray were recorded. And the effectiveness and outcome of bubble CPAPwere studied. Results: Out of the total of 73 cases, 53(72.60%) were treated successfully, while20(27.40%) failed bubble CPAP. Conclusion: Bubble CPAP is the safe primary mode of respiratorysupport in Preterm newborns with mild to moderate RDS, more effective with early Initiation and inPreterm babies born to mothers with the use of antenatal steroids.

Bubble CPAP for respiratory distress syndrome in preterm infants

2010 ◽  
Vol 47 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Jagdish Koti ◽  
Srinivas Murki ◽  
Pramod Gaddam ◽  
Anupama Reddy ◽  
M. Dasaradha Rami Reddy
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Bubble Cpap

scholarly journals Study of respiratory distress syndrome in newborn with special reference to the role of bubble CPAP in its management

2017 ◽  
Vol 4 (4) ◽  
pp. 1334
Author(s):  
Avi Sanghvi ◽  
Manish Rasania
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Low Flow ◽  
Positive Pressure ◽  
P Value ◽  
Antenatal Steroids ◽  
Bubble Cpap ◽  
Grade 3 ◽  
Cpap Failure

Background: Respiratory distress syndrome is the most important cause of morbidity and mortality in preterm neonates. Intermittent positive pressure ventilation with surfactant therapy was standard treatment of RDS. IIPV is invasive, costly and requires expertise. It is not a viable option for many of the resource limited SNCU set ups of our country. Trials have showed that CPAP is noninvasive, easy to use, safe and effective. This study was done to find out effectiveness of CPAP in RDS, and also to find CPAP failure factors.Methods: This was a prospective observational study, carried out at SNCU of Dhiraj hospital, Piparia, Vadodara district, Gujarat, India form February 2014 to March 2015. Neonates with diagnosis of respiratory distress syndrome were included in this study.Results: Total 57 (42 inborn and 15 out born) cases of RDS were analyzed in this study. Incidence of RDS was 3.68% of live births. 5(8.8%) settled down with low flow oxygen only. 24 (42.1%) successfully treated with CPAP only. 15 (26.3%) were treated with CPAP and surfactant. 13 (22.8%) were CPAP failure cases which required ventilator support. The variables significantly associated with failure of CPAP were: no exposure to antenatal steroids (p value of 0.025), grade 3-4 RDS on CXR (p value of 0.03), PDA (p value of 0.0264), sepsis/pneumonia (p value of <0.001) and Silverman Anderson score of ≥7 at admission (p value of 0.001). 3 (5.3%) went on DAMA. 5 (8.8%) expired and 49 (85.9%) were discharged. 4 out of 5 (80%) death occurred in very preterm group. 4 (80%) of death occurred in neonates whose mothers did not receive any dose of antenatal steroid. There was no mortality in neonates who were in need of surfactant and received within 6 hours of life. 75% of neonates having sepsis and asphyxia both along with RDS expired.Conclusions: Bubble CPAP is safe and very effective in low resource settings. CPAP failure is significantly associated with no antenatal steroids, grade 3 to 4 x-ray changes of RDS, Silverman Anderson score of ≥7 at beginning of CPAP, presence of significant PDA and association of sepsis/pneumonia. 

USE OF EARLY NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN TREATMENT OF PRETERM NEONATES WITH HYALINE MEMBRANE DISEASE (NEONATAL RESPIRATORY DISTRESS SYNDROME)

2021 ◽  
pp. 15-17
Author(s):  
Ranjeet Kumar ◽  
Aarti Sharma ◽  
Falak Naaz ◽  
Zeeshan Ahmed
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Severe Disease ◽  
Effective Means ◽  
Neonatal Respiratory Distress Syndrome ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Antenatal Steroids ◽  
Neonatal Respiratory Distress

Objective:To evaluate the outcome of early nasal CPAPin premature neonates with neonatal respiratory distress syndrome. Methods: 100 babies of 28-34 weeks gestational age admitted in Neonatal ICU of Nalanda Medical College & Hospital, Patna (Bihar, India), with clinical diagnosis of HMD, requiring respiratory support were treated with early nasal CPAPand studied prospectively from 1st November 2014 to 31st October 2016. Results: We found a success rate of 80% in babies with HMD, who were managed with early nasal CPAPalone. Remaining 20% needed intubation and higher mode of ventilation. Mild and moderate grade HMD were effectively managed with early nasal CPAP (P<0.05). It was also found to be effective in babies of mothers who have received antenatal steroids (P<0.05). Conclusion: Prematurity is the commonest predisposing cause for HMD. Early nasal CPAPis safe, inexpensive and effective means of respiratory support in HMD. It is useful in mild and moderate grade disease. It may not be a replacement for assisted ventilation in severe disease. It is also found to be more effective in babies of mothers who have received antenatal steroids.

scholarly journals Association of Antenatal Corticosteroid Administration-to-delivery Interval With Neonatal Respiratory Distress Syndrome and Respiratory Support in Preterm Infants

2022 ◽  
Author(s):  
Lixia Li ◽  
Haijing Li ◽  
Yejun Jiang ◽  
Beimeng Yu ◽  
Xiuren Wang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Preterm Infants ◽  
Birth Interval ◽  
Distress Syndrome ◽  
Delivery Room ◽  
Respiratory Support ◽  
Neonatal Respiratory Distress

Abstract Background: Administration of antenatal corticosteroids (ACS) is an effective strategy for the management of preterm infants, which can improve neonatal respiratory distress syndrome (NRDS) and attenuate the risk of neonatal mortality. However, many preterm infants do not expose to a complete course of ACS administration, and the effects of different ACS-to-delivery intervals on NRDS and respiratory support remain unclear.we explore the relationships of ACS administration-to-birth intervals with NRDS and respiratory support in preterm infants in this study.Methods: In this retrospective cohort study, the preterm infants born between 240/7 and 316/7 wk of gestation were recruited from Jan 2015 to Jul 2021. All participants were categorized based on the time interval from the first ACS dose to delivery: <24 h, 1-2 d, 2-7 d, and more >7 d. Multivariable logistic regression analysis was conducted to examine the relationships between ACS-to-birth interval and primary or secondary outcome, while adjusting for potential confounders.Results: Of the 706 eligible neonates, 264, 83, 292 and 67 received ACS-to-delivery intervals of <24 h, 1-2 d, 2-7 d and >7 d, respectively. After adjusting these confounding factors, multivariable logistic analysis showed a significant increased risk of NRDS (aOR: 1.8, 95% CI: 1.2-2.7), neonatal mortality (aOR: 2.8, 95% CI: 1.1-6.8), the need for surfactant use (aOR: 2.7, 95% CI: 1.7-4.4), endotracheal intubation in delivery room (aOR: 1.9, 95% CI: 1.0-3.7), mechanical ventilation (aOR: 1.9, 95% CI: 1.1-3.4) in the ACS-to-delivery interval of <24 h group when compared with the ACS-to-birth interval of 2-7 d group. Similar findings were observed in the subgroup analysis of the ACS interval of <6 h and 6-12 h groups (incidence of death and surfactant use), but no obvious differences were found in the ACS intervals of 12-24 h, 1-2 d and >7 d groups compared with the ACS-to-birth interval of 2-7 d group.Conclusions: Neonatal outcomes such as NRDS, neonatal mortality, the need for surfactant use, intubation in delivery room, mechanical ventilation are at a higher risk when the neonates exposed to ACS interval for less than 12 h before delivery.

scholarly journals Trial of aerosolised surfactant for preterm infants with respiratory distress syndrome

2021 ◽  
pp. fetalneonatal-2021-321645
Author(s):  
Luke Jardine ◽  
Kei Lui ◽  
Helen G Liley ◽  
Timothy Schindler ◽  
James Fink ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Failure Criteria ◽  
Open Label ◽  
Dose Escalation Study ◽  
Safety Issues ◽  
Label Dose ◽  
Historical Controls

ObjectiveTo evaluate the safety of an aerosolised surfactant, SF-RI 1, administered via nasal continuous positive airway pressure (nCPAP) and a prototype breath synchronisation device (AeroFact), to preterm infants with respiratory distress syndrome (RDS).DesignMulticentre, open-label, dose-escalation study with historical controls.SettingNewborn intensive care units at Mater Mothers’ Hospital, Brisbane, and Royal Hospital for Women, Sydney, Australia.PatientsInfants 26 weeks through 30 weeks gestation who required nCPAP 6–8 cmH2O and fraction of inspired oxygen (FiO2) <0.30 at <2 hours of age.InterventionsIn part 1, infants received a single dose of 216 mg/kg of aerosolised surfactant. In part 2, infants could receive up to four doses of aerosolised surfactant. Three historical control infants were matched for each enrolled infant.Main outcome measuresTreatment failure was defined as Respiratory Severity Score (FiO2×cmH2O nCPAP) >2.4, nCPAP >8 cmH2O, arterial carbon dioxide >65 mm Hg, pH <7.20 or three severe apnoeas within 6 hours during the first 72 hours of life. Other outcomes included tolerance of the AeroFact treatment and complications of prematurity.Results10 infants were enrolled in part 1 and 21 in part 2 and were compared with 93 historical controls. No safety issues were identified. In part 2, 6 of 21 (29%) AeroFact-treated infants compared with 30 of 63 (48%) control infants met failure criteria. Kaplan-Meier analysis of patients in part 2 showed a trend towards decreased rate of study failure in the AeroFact-treated infants compared with historical controls (p=0.10).ConclusionThe AeroFact system can safely deliver aerosolised surfactant to preterm infants with RDS who are on nCPAP.Trial registration numberACTRN12617001458325.

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