| dc.description.abstract | Background; The premature neonate is particularly susceptible to Respiratory distress Syndrome. This is due to the inherent lack of pulmonary surfactant. Mechanical ventilation has been used as the conventional therapy and is associated with a high cost of maintenance and establishment. It is labour intensive, requires high level of expertise as well as the man hours that are employed. Significantly is the associated increased incidence of Chronic Lung Disease (CLD). Newer strategies in the management of RDS that are associated with gentler ventilation are being employed and these include the use of Bubble Continuous Positive Airway Pressure (BCPAP).
Objectives: The purpose of this study was to describe the experience of the use of BCPAP for preterm neonates with Respiratory Distress Syndrome (RDS) at the AIC Kijabe Hospital.
Methodology; This was a short longitudinal survey. The study included 61 preterm neonates with RDS admitted at the AIC Kijabe Hospital new born unit who satisfied the inclusion criteria. The study period was 7 months. The outcomes of interest included duration of BCP AP support in days, duration of oxygen therapy and oxygen requirements at 36 weeks Gestational Age (GA). Other outcomes evaluated were; gestational age of the infants when full enteral feeds were tole-ated, and the complications of BCPAP.
Analysis: The normally distributed variables were represented as medians (range). The maternal, infant and clinical data were compared between infants who succeed CPAP. P value of 0.05 was considered to be significant.
Results: 61 preterm neonates were recruited in the study, 54.1% male and 45.9% female. 91% of the neonates started BCP AP on day one of life. The neonates were classified based on Birth weight as LBW<2500 gms (23), VLBW<1500gms (26) and ELBW<1000gms (12). The median duration of BCPAP treatment was 5 days (IQR 3 to 7 days), and this was significantly associated with Birth Weight (p=O.044). The median duration of Oxygen therapy was 6 days (lQR 4-17 days), and this was significantly associated with GA (p=0.003). 20% of the neonates had CLD requiring Oxygen administration at 36 weeks for 82% of the sample. The median age of full enteral feeds was 18 days (IQR 12- 25 days). There was no report of the major complications of BCPAP in the study i.e. pneumothorax. CPAP belly or nasal trauma. The mortality rate of preterms treated with BCPAP was 13.1 %.
Conclusion; Bubble CPAP is a safe mode of respiratory support for preterm neonates with RDS at the AIC Kijabe hospital and was associated with a mortality rate of 13.1 %. The duration of respiratory support i.e. duration of BCP AP therapy and oxygen therapy was 5 and 6 days respectively. Ten (20%) neonates required continued oxygen use beyond 36 weeks GA.The use of Bubble CPAP was associated with achievement of full enteral feeding at a median age of 18 days. No complications were reported among the premature neonates who were treated with Bubble CP AP. | en_US |
