Efficacy of Indigenous Bubble CPAP in Neonates withRespiratory Distress

Abstract

Background: Respiratory distress in newborn due to varied aetiology is one of the common causes for new born admission to NICU, new born morbidity and mortality. Bubble CPAP is a simple, cost effective and gentle mode of respiratory support in newborns with respiratory distress. It reduces the need for mechanical ventilation in appropriately selected cases. In this paper we review our institute experience of using very low cost indigenous CPAP as primary way of respiratory support and its outcome. Objectives: Effectiveness of indigenous CPAP as a low cost measure in treatment of respiratory distress in newborn period and its outcome. Design: Prospective observational study. Subjects and Methods: This study included 100 consecutive both term and preterm newborns admitted for respiratory distress due to varied aetiologies like respiratory distress syndrome, transient tachypnea of newborn, apnea of prematurity, birth asphyxia, meconium aspiration syndrome, etc in our NICU over a period of 1 year. Exclusion criteria being babies put on CPAP for post-extubation respiratory distress and babies with severe life threatening surgical conditions. Downe's scoring for term and Silvermann's scoring for preterm babies were used to assess the severity of respiratory distress and also to assess the response to indigenous CPAP. Results: Out of 100 newborns with respiratory distress treated with indigenous CPAP, 73% improved, 21% were further put on mechanical ventilation and 6% were discharged against medical advise. Failure of CPAP was associated with co morbidities like sepsis, congenital heart diseases, PPHN and IVH. Conclusion: Indigenous bubble CPAP is low cost equipment (Total cost Rs.301) effective in treatment of respiratory distress in newborn at resource limited neonatal intensive care units where newborn admissions are in excess.

Healthcare Innovation and Design Thinking

“…This has worked reasonably well in the management of the RDS in term and preterm newborns and many would agree with it. [6,7] Another example is the use of styrofoam boxes as baby warmers especially for preterm/LBW babies in home setting, PHCs, during transport. [8] Now, what if a clinician applies their innovative potential in solving other problems of the system?…”