Bubble CPAP for respiratory distress syndrome in preterm infants.

OBJECTIVES To ascertain the immediate outcome of preterm infants with respiratory distress syndrome (RDS) on Bubble CPAP and identify risk factors associated with its failure. STUDY DESIGN Prospective analytical study. SUBJECTS Inborn preterm infants (gestation 28 to 34 weeks) admitted to the NICU with respiratory distress and chest X ray suggestive of RDS. INTERVENTION Bubble CPAP with bi-nasal prongs. PRIMARY OUTCOME CPAP failures infants requiring ventilation in the first one week. RESULTS 56 neonates were enrolled in the study. 14 (25%) babies failed CPAP. The predictors of failure were; no or only partial exposure to antenatal steroids, white-out on the chest X-ray, patent ductus arteriosus, sepsis/pneumonia and Downes score > 7 or FiO2 > or = 50% after 15-20 minutes of CPAP. Other maternal and neonatal variables did not influence the need for ventilation. Rates of mortality and duration of oxygen requirement was significantly higher in babies who failed CPAP. Only two infants developed pneumothorax. No baby had chronic lung disease. CONCLUSION Infants with no or partial exposure to antenatal steroids, white-out chest X-ray, patent ductus arteriosus, sepsis/pneumonia and those with higher FiO2 requirement after initial stabilization on CPAP are at high risk of CPAP failure (needing mechanical ventilation). Bubble CPAP is safe for preterm infants with RDS.