Use of Bubble CPAP in Preterm Neonates with Respiratory Distress at a Tertiary Care Hospital

Authors

  • Muhammad Naveed Khani Senior Registrar National Institute of Child Health, Rafique Shaheed Road Karachi
  • Hira Waseem National Institute of Child Health Karachi
  • Muhammad Ashfaq National Institute of Child Health, Rafique Shaheed Road Karachi.
  • Bader -U- Nisa National Institute of Child Health Rafique shaheed road Karachi
  • Aijaz Ahmed National Institute of Child Health Rafique shaheed road Karachi

DOI:

https://doi.org/10.36570/jduhs.2022.2.1192

Keywords:

Bubble CPAP, Preterm Neonates, Respiratory Distress

Abstract

Objective: To determine the outcome of Bubble Continuous Positive Airway Pressure (bCPAP) Therapy use in preterm neonates with respiratory distress admitted in large public sector children hospital.
Methods: This prospective observational study was conducted at National Institute of Child Health (NICH) from March 2016 to February 2017. All preterm neonates with respiratory distress diagnosed within 24 hours treated with bCPAP were consecutively included. Respiratory distress was defined on the basis of presence of any of the three following symptoms (i) tachypnea (ii) chest indrawing (iii) grunting (iv) nasal flaring (v) hypoxemia. Outcome was measured in terms of survival, median for duration to achieve 21% O2 , apnea, hyperemia of nose, abdominal distention, median for hospital stay, and median weight gain.
Results: Of 70 preterm neonates, the median birth weight was 2700 (2300 – 3000) gm, duration to achieve 21% O2 was 3 (2 – 72) hours, and hospital stay was 8 (6–10) days. The complications of bubble CPAP showed that abdominal distension was found higher followed by hyperemia of nose and apnea i.e., 18 (25.7%), 17 (24.3%), and 4 (5.7%) respectively. Survival was found significantly associated with birth weight (p-value 0.049) and in neonates with no complications (p-value <0.001). Whereas apnea was found significantly higher in female preterm neonates (p-value 0.017), low birth weight (p-value 0.012) and in neonate who reported no survival (p-value <0.001).
Conclusion: The administration of bCPAP is an effective modality for managing respiratory illness in preterm Neonates due to fewer complications and shorter hospital stay.

Downloads

Download data is not yet available.

References

Shi Y, Muniraman H, Biniwale M, Ramanathan R. A Review on Non-invasive Respiratory Support for Management of Respiratory Distress in Extremely Preterm Infants. Front Pediatr 2020; 8:270.

doi: 10.3389/fped.2020.00270.

Kommawar A, Borkar R, Vagha J, Lakhkar B, Meshram R, Taksandae A. Study of respiratory distress in newborn. Int J Contemp Pediatr 2017; 4:490-94.

doi 10.18203/2349-3291.

McPherson C, Wambch JA. Prevention and Treatment of Respiratory Distress Syndrome in Preterm Neonates. Neonatal Netw; 37:169-77.

doi: 10.1891/0730-0832.37.3.169.

Vijayasekaran S. Pediatric Airway Pathology. Front Pediatr 2020; 8:246.

doi: 10.3389/fped.2020.00246.

Alessi S. Evidence Regarding the Uses of Bubbles Continuous Positive Airway Pressure in the Extremely Low Birth-Weight Infant: Benefits, Challenges, and Implications for Nursing Practice. Adv Neonatal Care 2018; 18:199-207.

doi: 10.1097/ANC.0000000000000509.

Ekhaguere OA, Mairami AB, Kirpalani H. Risk and ben-efits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries. Paediatr Respir Rev 2019; 29:31-6.

doi: 10.1016/j.prrv.2018.04.004.

Ekhaguere O A, Mairami A B, Kirpalani H. Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries. Paediatr Respir Rev 2019; 29:31-6.

doi: 10.1016/j.prrv.2018.04.004.

Kawaza K, Machen HE, Brown J, Mwanza Z, Iniguez S, Gest A, et al. Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi. PLoS One 2014; 9:e86327. doi: 10.1371/journal.pone.0086327.

Gupta S, Donn SM. Continuous Positive Airway Press-ure: To Bubble or Not to Bubble? Clin Perinatol 2016; 43:647-59. doi: 10.1016/j.clp.2016.07.003.

Jensen EA, Chaudhary A, Bhutta ZA, Kirpalani H. Non-invasive respiratory support for infants in low- and middle-income countries. Semin Fetal Neonatal Med 2016; 21:181-8. doi: 10.1016/j.siny.2016.02.003.

Ho JJ, Subramaniam P, Davis PG. Continuous positive airway pressure (CPAP) for respiratory distress in preterm infants. Cochrane Database Syst Rev 2020; 10:CD002271. doi: 10.1002/14651858.

Gupta S, Donn SM. Continuous positive airway pres-sure: Physiology and comparison of devices. Semin Fetal Neonatal Med 2016; 21:204-11.

doi: 10.1016/j.siny.2016.02.009.

aldursdottir S, Falk M, Donaldsson S, Jonsson B, Drevhammar T. Basic principles of neonatal bubble CPAP: effects on CPAP delivery and imposed work of breathing when altering the original design. Arch Dis Child Fetal Neonatal Ed 2020; 105:550-4.

doi: 10.1136/archdischild-2019-318073.

Audu LI, Otuneye AT, Mairami AB, Mukhtar MY. Improvised bubble continuous positive airway pressure (bCPAP) device at the National Hospital Abuja gives immediate improvement in respiratory rate and oxygenation in neonates with respiratory distress. Niger J Paediatr 2015; 42:12-6.

Okello F, Egiru E, Ikiror , Acom L, Loe K, Olupot-Olupot P, et al. Reducing preterm mortality in eastern Uganda: the impact of introducing low-cost bubble CPAP on neonates <1500 g. BMC Pediatr 2019; 19:311. doi: 10.1186/s12887-019-1698-x.-7.

Switchenko N, Kibaru E, Tsimbiri P, Grubb P, Anderson Berry A. Implementation of a Bubble CPAP Treatment Program for Sick Newborns in Nakuru,

Kenya: A Quality Improvement Initiative. Glob Pediatr Health 2020; 7:2333794X20939756.

doi: 10.1177/2333794X20939756.

Kleinhout MY, Stevens MM, Osman KA, Adu-Bonsaff-oh K, Groenendaal F, Biza Zepro N, et al. Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Glob Health 2021; 6:e003618. doi: 10.1136/bmjgh-2020-003618.

Ramaswamy VV, More K, Roehr CC, Bandiya P, Nangia S. Efficacy of noninvasive respiratory support modes for primary respiratory support in preterm neonates with respiratory distress syndrome: Systematic review and network meta-analysis. Pediatr Pulmonol 2020; 55:2940-63. doi: 10.1002/ppul.25011.

Courtney SE, Kahn DJ, Singh R, Habib RH. Bubble and ventilator-derived nasal continuous positive airway pressure in premature infants: work of breathing and gas exchange. J Perinatol 2011; 31:44-50.

doi: 10.1038/jp.2010.55.

Koyamaibol L, Kado J, Qovu JD, Colquhoun S, Duke T. An evaluation of bubble-CPAP in a neonatal unit in a developing country: effective respiratory support that can be applied by nurses. J Trop Pediatr 2006; 52:249-53.

doi: 10.1093/tropej/fmi109.

Mathai S S, Rajeev A, Adhikari KM. Safety and effectiveness of bubble continuous positive airway pressure in preterm neonates with respiratory distress. Med J Armed Forces India 2014; 70:327-31. doi: 10.1016/j.mjafi.2013.08.003.

Downloads

Published

2022-01-05

How to Cite

Khani, M. N., Waseem, H., Ashfaq, M., Nisa, B. .-U.-., & Ahmed, A. (2022). Use of Bubble CPAP in Preterm Neonates with Respiratory Distress at a Tertiary Care Hospital. Journal of the Dow University of Health Sciences (JDUHS), 16(2), 66–71. https://doi.org/10.36570/jduhs.2022.2.1192

Issue

Section

Original Articles

Most read articles by the same author(s)