Effect of Bubble and Ventilator-derived Continuous Positive Airway Pressure on the Management of Respiratory Distress Syndrome in Premature Neonates

Background: In this study, we aimed to compare ventilator-derived and bubble continuous positive airway pressure (CPAP) in neonates with respiratory distress syndrome admitted to Neonatal Intensive Care Unit of Vali-e-Asr Hospital, Birjand, Iran, in 2014. Methods: This cohort study was conducted among 68 patients assigned into two groups. The neonates in group A (32 infants) were treated with bubble CPAP and those in group B (36 infants) were treated with a ventilator-derived CPAP. The protocol of treatment was applying CPAP with the positive end-expiratory pressure (PEEP) of 5-6 cm H2O and fraction of inspired oxygen equivalent to 30-40%, depending on the gestational age. In case of need for higher oxygen levels to maintain oxygen saturation of arterial blood (SpO2) (90-95%), surfactant was administered and additional PEEP was applied (up to 8 cm H2O). Data analysis was performed using independent t-test and Chi-squared in the SPSS software, version 18. Results: The duration of CPAP and oxygen therapy was 1.67±1.22 days and 3.57±2.67 days in group A and 2.09±1.53 days (P=0.21) and 4.67±3.74 days (P=0.16) in group B, respectively. There was a significant difference between the groups in terms of discharge weight and surfactant dosage (P=0.042 and P=0.007, respectively). Moreover, although the length of stay in hospital in the ventilation group was almost 4 days longer than the other group, there was no significant difference between the groups in this regard. Conclusion: There was no significant difference between bubble CPAP and ventilator-derived CPAP. Moreover, further studies with larger sample size are recommended.