scholarly journals Outcome of Locally Assembled Continous Positive Airway Pressure Device in Neonates with Respiratory Distress in Low Resource Setting

2021 ◽  
Vol 23 (4) ◽  
pp. 297-301
Author(s):  
Sabina Shrestha ◽  
Sujit Kumar Shrestha ◽  
Gentle Sunder Shrestha ◽  
Madhu Sudan Dhakal
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Low Cost ◽  
College Teaching ◽  
Limited Resource ◽  
Positive Pressure ◽  
Cross Sectional ◽  
Resource Setting

Respiratory distress is the most frequent cause of neonatal admission in neonatal intensive care unit (NICU). Continuous Positive Airway Pressure (CPAP) is an effective mode of treatment in newborn with respiratory distress. CPAP is the application of positive pressure to the airways of spontaneously breathing patient throughout the respiratory cycle. Low cost CPAP can be locally assembled and used in neonates with respiratory distress to reduce the mortality. This is a cross sectional descriptive study conducted in NICU of Nepal Medical College Teaching Hospital from the period of June 2021 to September 2021 to assess the outcome of locally assembled CPAP. A total of 96 newborns with respiratory distress were included in the study. Severity of respiratory distress was assessed by Downes score. Downes score before and after CPAP were recorded. Newborn with Downes score of ≥4 was started with locally assembled CPAP. Outcome was taken as improvement when the respiratory distress was decreased with Downes score<4. And it was taken as a failure when baby required mechanical ventilation. Mean Downes score before starting CPAP was 4.81 and after CPAP was 0.51. Mean CPAP pressure was 4.27cm of water. Outcome of study showed, 80 (83.3%) babies were improved, 7 (7.3%) had failed CPAP who required mechanical ventilation and 1 (1%) baby expired. In conclusion, locally assembled CPAP shown to be equally effective as standard CPAP device and can be used as an effective alternative to mechanical ventilator in developing country with limited resource setting.

scholarly journals Non-invasive duo positive airway pressure ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arash Malakian ◽  
Mohammad Reza Aramesh ◽  
Mina Agahin ◽  
Masoud Dehdashtian
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Abstract Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002). Conclusions In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group. Trial registration IRCT20180821040847N1, Approved on 2018-09-10.

Care of the Neonate on Nasal Continuous Positive Airway Pressure: A Bedside Guide

2018 ◽  
Vol 37 (1) ◽  
pp. 24-32
Author(s):  
Jennifer M. Guay ◽  
Dru Carvi ◽  
Deborah A. Raines ◽  
Wendy A. Luce
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Respiratory Distress ◽  
Parent Education ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Clinical Manifestations ◽  
Neonatal Morbidity ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Team Approach

Respiratory distress continues to be a major cause of neonatal morbidity. Current neonatal practice recommends the use of nasal continuous positive airway pressure (nCPAP) in the immediate resuscitation and continued support of neonates of all gestations with clinical manifestations of respiratory distress. Despite the many short- and long-term benefits of nCPAP, many neonatal care units have met resistance in its routine use. Although there have been numerous recent publications investigating the use and outcomes of various modes of nCPAP delivery, surfactant administration, mechanical ventilation, and other forms of noninvasive respiratory support (high-flow nasal cannula, nasal intermittent positive pressure ventilation), there has been a relative lack of publications addressing the practical bedside care of infants managed on nCPAP. Effective use of nCPAP requires a coordinated interprofessional team approach, ongoing assessment of the neonate, troubleshooting the nCPAP circuit, and parent education.

scholarly journals Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Sunil Raja Manandhar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Positive Airway Pressure ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Neonatal Intensive Care ◽  
Positive Airway Pressure ◽  
College Teaching ◽  
Medical College

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

Comparison of Early Nasal Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure in Preterm Infants with Respiratory Distress Syndrome

2018 ◽  
Vol 65 (4) ◽  
pp. 352-360 ◽  
Author(s):  
Mesut Dursun ◽  
Sinan Uslu ◽  
Ali Bulbul ◽  
Muhittin Celik ◽  
Umut Zubarioglu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure

Abstract Aims To compare the effect of early nasal intermittent positive pressure ventilation (nIPPV) and nasal continuous positive airway pressure (nCPAP) in terms of the need for endotracheal ventilation in the treatment of respiratory distress syndrome (RDS) in preterm infants born between 24 and 32 gestational weeks. Methods This is a randomized, controlled, prospective, single-centered study. Forty-two infants were randomized to nIPPV and 42 comparable infants to nCPAP (birth weight 1356 ± 295 and 1359 ± 246 g and gestational age 29.2 ± 1.7 and 29.4 ± 1.5 weeks, respectively). Results The need for endotracheal intubation and invasive mechanical ventilation was significantly lower in the nIPPV group than the nCPAP group (11.9% and 40.5%, respectively, p < 0.05). There were no differences in the duration of total nasal respiratory support, duration of invasive mechanical ventilation, bronchopulmonary dysplasia or other early morbidities. Conclusion nIPPV compared with nCPAP reduced the need for endotracheal intubation and invasive mechanical ventilation in premature infants with RDS.

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