Self-Assembled Bubble Continuous Positive Airway Pressure (CPAP) Device as Primary Respiratory Support for Neonatal Respiratory Distress in Low-Resource Settings

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Abstract

Background: Self-assembled, bubble continuous positive airway pressure is a low-cost noninvasive respiratory support modality used to manage newborns with respiratory distress. Very few local studies have been conducted regarding its use in the management of neonatal respiratory distress. This study was conducted to evaluate the effectiveness of this device as a primary treatment modality for neonatal respiratory distress.

Methods: This cross-sectional study was conducted in the Department of Pediatrics, Ziauddin Hospital, Karachi from 1^st February 2018-31^st July 2018 on neonates (n=200) admitted with respiratory distress, in whom self-assembled bubble continuous positive airway pressure was used as a primary respiratory support. The effectiveness of its use was determined, based on the absence of associated complications, signs of respiratory distress, and oxygen saturation at room air of 94% or more. Data were analyzed by SPSS version 20. The Chi-square test was used for categorical variables and a p-value <0.05 was considered statistically significant.

Results: The mean gestational age was 34.3+2.73 weeks, the mean age at initiation of bubble continuous positive airway pressure was 7.7 4 hours, and the mean duration of hospital stay was 4.2 days. The observed failure rate in the study population was 8.5%, while the mortality was only 2%. The finding of respiratory distress syndrome on chest- X-ray with (FiO2) > 60% was observed. In addition, bubble CPAP after 6 hours of the onset of respiratory distress showed significant results (p<0.001).

Conclusion: Self-assembled bubble continuous positive airway pressure is a significant and effective treatment modality (p=0.001) in neonatal respiratory distress.

Keywords: Bubble Continuous Positive Airway Pressure; Neonates; Respiratory Distress.