Success of Locally Devised Continuous Positive Pressure Ventilation (CPAP) alone or in combination with Surfactant Therapy in the Management of Respiratory Distress Syndrome in Preterm Neonates

Objective: To study the effect of implementing locally devised CPAP alone or in combination with INSURE protocol (Intubation, Surfactant, Extubation) in preterm neonates with respiratory distress syndrome in a tertiary care hospital. Methods: The study was conducted from August 2012 to August 2014 in Neonatal Intensive Care Unit (NICU) of Liaquat National Hospital, Karachi. Total 113 neonates were enrolled in the study. They were grouped in two categories on the basis of severity of respiratory distress syndrome (RDS). Infants with clinical evidence of respiratory distress and radiological evidence of patchy reticulogranularpattern were given a trial of bubble CPAPalone. Neonates with severe RDS were given INSURE protocol along with bubble CPAP. The intervention was considered to be successful if respiratory distress improved and the baby could be successfully weaned off from CPAP. Results: In this study 113 neonates were enrolled. Fifty neonates were initially managed with bubble CPAP alone out of which 29 (58%) improved. Neonates with severe RDS were 63 and received bubble CPAP along with INSURE protocol out of which 45 (71.4%) improved. Conclusion: Locally devised Bubble CPAP along with selective surfactant therapy is a safe and effective intervention in the management of respiratory distress syndrome in preterm. It decreases the need for mechanical ventilation and its subsequent complication.