Bubble CPAP therapy for neonatal respiratory distress in level III neonatal unit in Amman, Jordan: a prospective observational study

Abstract

PurposeBubble continuous positive airway pressure (bCPAP), a noninvasive respiratory support modality used to manage newborns with respiratory distress, provides continuous pressure that helps prevent derecruitment of alveoli, increasing the lungs’ functional residual capacity, and thus decreasing the work of breathing. bCPAP can be used to manage various respiratory conditions in the newborn. In this prospective study, we describe our experience using bCPAP therapy as the primary respiratory support in a level III neonatal unit in Amman, Jordan. In addition to reporting therapeutic indications, durations, and side effects, we aimed to identify areas requiring improvement in bCPAP therapy in our population.Patients and methodsThis prospective observational study investigated the usage of bCPAP in the management of respiratory distress in newborns admitted to a Jordan University Hospital in Amman. The newborns were followed until discharge. The patients’ demographic and clinical data were recorded.ResultsA total of 143 babies (mean gestational age, 36±2.7 weeks; mean birth weight, 2,770±1,800 g) were included. All received bCPAP as the primary respiratory support. The most common underlying cause of respiratory distress was transient tachypnea of the newborn (42%), followed by prolonged respiratory transition (34%). The therapy success rate was 93.7%; only nine infants failed bCPAP. The most common side effect was physical facial injury.ConclusionThe use of neonatal bCPAP therapy is well established in Jordan University Hospital. The area of potential improvement was the low rate of bCPAP use as a primary respiratory support in extremely premature infants.

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

“…These findings can be explained by the fact that a large majority of the neonates in our study were preterm i.e., 131 out of a total of 200 were of <35 weeks gestational age and therefore were more prone to these conditions. However, in a study on the use of bubble CPAP in neonates by Al-Lawama et al The most frequent etiology of respiratory distress was transient tachypnea of the newborn (TTN) seen in 42% of the study population 18 .…”

Experiences with implementation of continuous positive airway pressure for neonates and infants in low-resource settings: A scoping review

“…HCPs were more confident in their ability to use CPAP when the devices were simple and accompanied by quality training [ 26 , 32 , 34 ]. Several studies described nurses’ perceptions with CPAP treatment [ 26 , 34 , 35 , 41 , 43 , 62 ]. Dewez et al highlighted “ most nurses felt that trained nurses could initiate CPAP ‘ independently’” [ 34 ] and Atreya et al stated that a CPAP device provided “neonatal nurses with more autonomy” [ 26 ].…”

Randomized trial of mask or prongs for nasal intermittent mandatory ventilation in term infants with transient tachypnea of the newborn

“…Non‐invasive positive pressure ventilation is defined as ventilation of the neonate by conventional mechanical ventilation using continuous mandatory ventilation mode with the same setting used in mechanical ventilation but using nasal interfaces . Nasal intermittent positive pressure ventilation superimposes an intermittent peak pressure on CPAP, delivering both into the pharynx .…”