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Category: Volume 07 Issue 11 November 2019
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Title: A Study on the use of Early Nasal Continuous Positive Airway Pressure (CPAP) in Preterm Neonates with Hyaline Membrane Disease (Respiratory Distress Syndrome)

Authors: Dr B.Lakshmi Parvathi, Dr A. Vineela, Dr P. Venu Gopal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.96

Abstract

Introduction: HMD is the most common cause of respiratory distress in preterm neonates. Deficiency of pulmonary surfactant is one of the commonest factors contributing to development of RDS. CPAP as non-invasive respiratory support is an excellent option useful to avoid the harmful effects associated with invasive ventilation.

Objectives

  1. To find the incidence of premature neonates (<37 weeks) in our hospital.
  2. To find the incidence of HMD premature neonates with gestational age between 28-36 Weeks.
  3. To evaluate the effectiveness of early CPAP in preterm neonates with HMD.

Materials & Methods: It is Longitudinal Observational study conducted for 1 year duration from January 2018- December 2018. 50 inborn preterm neonates with diagnosed HMD admitted in SNCU, KGH were taken as subjects for this study..

Results: CPAP was admitted to 50babies out of total 130 inborn neonates diagnosed with HMD, from the period of 0-6hrs. Outcome with 80% success rate and 20%failed requiring higher mode of ventilation. The mean duration requiring CPAP in success group was 38.5 15hrs with range of 10-72hrs, whereas in failure group it is 9.0 1.7hrs with range of 8-12hrs. The effectiveness of CPAP was found to be 100% in mild HMD, 93% in moderate HMD and was only 46.67%  in severe HMD. Out of 10 babies who were ventilated 90% were less than 32wks gestational age.

Conclusion: In our study we report that prematurity is the commonest cause for HMD. Its incidence increases with decrease in birth weight & gestational age. Early nasal CPAP is useful in mild & moderate HMD with no significant effective outcome in severe HMD. It is safe, inexpensive and effective means of respiratory support in HMD.

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Corresponding Author

Dr B.Lakshmi Parvathi

Department of Paediatrics, Andhra Medical College, Visakhapatnam