Bubble CPAP for Respiratory Distress Syndrome in Preterm Infants

Objectives: To ascertain the immediate outcome of preterm infants with respiratory distress syndrome (RDS) on Bubble CPAP and identify risk factors associated with its failure. Study design: Prospective analytical study. Subjects: Inborn preterm infants (gestation 28 to 34 weeks) admitted to the NICU with respiratory distress and chest X-ray suggestive of RDS. Intervention: Bubble CPAP with bi-nasal prongs. Primary outcome: CPAP failures-infants requiring ventilation in the first one week. Results: 56 neonates were enrolled in the study. 14 (25%) babies failed CPAR The predictors of failure were; no or only partial exposure to antenatal steroids, white-out on the chest X-ray, patent ductus arteriosus, sepsis/pneumonia and Downe's score >7 or FiO(2) >= 50% after 15-20 minutes of CPAP. Other maternal and neonatal variables did not influence the need for ventilation. Rates of mortaility and duration of oxygen requirement was significantly higher in babies who failed CPAP. Only two infants developed pneumothorax. No baby had chronic lung disease. Conclusion: Infants with no or partial exposure to antenatal steroids, white-out chest X-ray, patent ductus arteriosus, sepsis/pneumonia and those with higher FiO(2) requirement after initial stabilization on CPAP are at high risk of CPAP failure (needing mechanical ventilation). Bubble CPAP is safe for preterm infants with RDS.