CORRELATION BETWEEN INITIAL PRESSURE AND DURATION ON BUBBLE CPAP IN NEONATES WITH RESPIRATORY DISTRESS ADMITTED IN NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE CENTRE

Background: Continuous Positive airway pressure (CPAP) is a non-invasive form of respiratory support, which is safe and effective in neonates with respiratory distress. The purpose of this study is to predict the length of stay on bubble CPAP in neonates by correlating the initial pressure and duration on it with respect to gestational age, birth weight and respiratory distress scores.

Objective: To correlate the initial pressure and duration on bubble CPAP in neonates with respiratory distress thereby predicting the length of stay on it and analyzing the factors responsible for bubble CPAP failure.

Materials and Methods: A prospective longitudinal study was conducted over a period of 2 years in neonates with respiratory distress requiring bubble CPAP. Applying Pearsoncoefficient, the initial pressure and duration on bubble CPAP was correlated with respect to different variables. The statistical analysis was performed using SPSS (Version 20.0). P value of <0.05 was considered as statistically significant.

Results: Out of 246 neonates enrolled, 211(85.77%) neonates were successfully treated with bubble CPAP, with mean birth weight of 1.66 kg and mean duration of stay on bubble CPAP was 32.64 hours. Applying Pearson co- efficient on initial pressure and duration on bubble CPAP there was negative correlation, which was statistically significant. 35(14.23%) failed bubble CPAP. The predictors of failure were prematurity (51.43%), birth asphyxia (8.6%), age at initiation of bubble CPAP, sepsis (8.57%), Downes score and Silverman Anderson score of more than 6. Other maternal and neonatal variables did not influence the need of mechanical ventilation.

Conclusion: The duration of stay on bubble CPAP and the initial pressure set are negatively correlated that is, higher the initial pressure there is significant reduction in duration on bubble CPAP thereby the length of stay can be predicted by initial pressure set.