1Department of Paediatrics, Sri Venkateshwaraa Medical College Hospital and Research Centre, Ariyur, Puducherry.
Background: Neonatal and perinatal mortality rates serve as crucial indicators of a nation's health status, reflecting the overall effectiveness of its healthcare system. A major contributor to neonatal mortality in India is respiratory distress, which accounts for approximately 32-52% of neonatal deaths. Respiratory distress is one of the most common issues faced by newborns worldwide, affecting 3-7% of all live births. Assisted ventilation plays a pivotal role in the management of respiratory distress in neonates. Invasive ventilation, though potentially lifesaving, is one of the most expensive therapies in neonatal intensive care units (NICUs). On the other hand, non-invasive ventilation, particularly Bubble CPAP (Continuous Positive Airway Pressure), offers several advantages. It is relatively simple, cost-effective, and can be monitored with a pulse oximeter. With proper training, Bubble CPAP has been shown to be highly effective in managing neonatal respiratory distress, with fewer long-term complications compared to invasive methods. Hence, this study aims to study the outcome of noninvasive ventilation using Bubble CPAP in neonates with respiratory distress admitted in Newborn Unit in tertiary care hospital.
Materials and Method: A prospective observational study with successive sampling was conducted, and 100 newborns who met the inclusion criteria were included. For newborns with a Downes score of 4–6, a Silverman score of >4, or chronic hypoxemia, bubble CPAP (Fisher & Paykel) was started after stabilization. Secure prong installation, humidification, suctioning, gastric decompression, and monitoring for problems such prong displacement, nasal obstruction, mucosal ulceration, and pneumothorax were the main focuses of nursing care. SPSS was used to do the statistical analysis.
Results: Silverman's score indicated that 73% of neonates evaluated prior to bubble CPAP therapy had moderate respiratory distress, and 27% had severe respiratory distress. By contrast, Downes scoring revealed that 68% had moderate distress (5–6), 28% had severe (>7), and 4% had mild (<4). 95% of people survived overall, whereas 5% died. Interestingly, there were no fatalities in the mild or moderate groups, whereas the severe cases had a 17.9% fatality rate. Although it had no impact on overall hospital stay, early CPAP beginning was associated with better survival and shorter therapy duration. Prolonged hospital stays were associated with greater Silverman's scores and severity of distress, highlighting the importance of disease burden in healthcare. Although there were survivors in every Downes category, the groups with lower scores had the highest survival rates, indicating the positive outcomes with less severe initial distress. These results demonstrate that baseline severity is still the best indicator of hospital stay duration and overall outcome, while also highlighting the efficacy of bubble CPAP in lowering infant mortality and the significance of prompt commencement.
Conclusion: The present study findings highlight the importance of initiating CPAP early in neonates with respiratory distress to improve survival and reduce complications. Longer hospital admissions and worse morbidity were associated with severe cases, which were identified by higher Silverman's and Downes scores. This underscores the significance of early identification, fast intervention, and careful monitoring to maximize results.
Keywords: Neonates, Respiratory distress, Bubble CPAP (Continuous Positive Airway Pressure), Silverman's score, Downes score.
How to cite this article: Manoj Kumar K, Kulandaivel M, Vijayabharathi E, Manoharan E, Latha V. Outcome of Bubble CPAP Ventilation in NICU, Puducherry. Int J Drug Deliv Technol. 2026;16(15s): 637-647. DOI: 10.25258/ijddt.16.15s.74
Source of support: Nil.
Conflict of interest: None