Bubble cpap copy

DR.YOGESH BHADANI,

DR.NILESH PANCHAL,

DR.K.M.MEHARIYA

B.J.M.C , CIVIL HOSPITAL, AHMEDABAD.

INTRODUCTION Bubble CPAP is simple, inexpensive and gentle

method of respiratory support in pre terms

It prevents the alveolar collapse with marginal stability.

Better recruitment of alveoli thus increases the functional capacity of lungs .

It result in less ventilator induced lung injury than mechanical ventilation, hence reduce incidence of chronic lung disease

Oscillations produced by continuous bubbling contribute to gas exchange

It can identify large leaks at nares ( bubbling stops )

It maintain more uniform pressure.

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Oscillations produced by continuous bubbling contribute to gas exchange

It can identify large leaks at nares ( bubbling stops )

It maintain more uniform pressure.

AIMS AND OBJECTIVES The present study was conducted

to study the effectiveness of bubble CPAP in pre-terms with RDS

MATERIALS AND METHODThe present study was carried out on 72 pre-terms who presented within 6 hours of birth

DESIGN : A prospective analysis

SETTING : NICU , Department of paediatrics ,

B.J.Medical College ,Civil hospital ,Ahmedabad.

STUDY PERIOD : 1-1-2010 to 20-5-2010

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We recorded following data of each patients

Maturity ,sex and weight

presentation time after birth

Downe’s score on arrival

Duration of bubble CPAP

Failure

Recurrent apnea

Survival rate

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All pre-terms meeting our criteria randomisedaccording to gestational age

36 patients as case put on bubble CPAP and 36 patients as control given other conventional therapy like oxygen with head box or with nasal prongs

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All pre-terms meeting our criteria randomised according to gestational age .

36 patients as case put on bubble CPAP and 36 patients as control given other conventional therapy like oxygen with head box or nasal prongs

SELECTION CRITERIA Preterms presented with RDS admitted within 6 hours

of birth in NICU BJMC.

EXCLUSION CRITERIA Pre-terms presented with RDS Admitted after 6 hours

of birth.

Other causes of RDS like hypoglycemia,septicemia and metabolic disorders.

Patients not completed treatment

OBSERVATIONCASE CONTROL

MALE 21 20

FEMALE 15 16

M:F Ratio 1.4:1 1.25:1

WEIGHT CASE CONTROL

<1 Kg 6 (16.66%) 7 (19.44%)

1-1.5 Kg 12 (33.33%) 14 (38.88%)

1.5-2 Kg 18 (50%) 15 (41.66%)

.PRESENTATION

CASE CONTROL

At Birth 5 (13.88%) 8 (22.22%)

Within 2 hrs. 14 (38.88%) 13 (36.11%)

2-6 hrs. 17 (47.22%) 15 (41.66%)

DOWNE’S SCORE

CASE CONTROL

2-4 20 (55.55%) 22 (61.11%)

4-6 14 (38.88%) 13 (36.11%)

>6 2 (5.55%) 1 (2.77%)

.CASE CONTROL

RecurrentApnea

6 (16.66%) 8 (22.22%)

.CASE CONTROL

VentilatorySupport

3 (8.33%) 5 (13.88%)

DURATION OF CPAP

3-4 Days 8 (22.22%)

4-5 Days 10 (27.77%)

5-7 Days 15 (41.66%)

Failure 3 (8.33%)

.CASE CONTROL

SURVIVALRATE

33 (91.66%) 30 (83.33%)

CONCLUSION Bubble CPAP has markedly reduced mortality due to

RDS in pre terms.

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