Comparison of Continuous Positive Airway Pressure Therapy with and Without Surfactant in Neonatal Respiratory Distress Syndrome
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 9
Abstract
Neonatal respiratory distress syndrome is an important cause of morbidity and mortality in preterm neonates. Recognition of adverse effects related to mechanical ventilation, led researchers to explore various non-invasive forms of respiratory support. This is a retrospective comparative study done to determine the efficacy of CPAP alone in comparison to that of CPAP with surfactant in the treatment of RDS. The primary objective was determining proportion of babies who could be weaned off without the need for mechanical ventilation. Methods: The study group contained 124 preterm babies between 28 and 32 weeks of gestational age with RDS. Forty two (33.8%) babies were managed on CPAP alone (groupA) and 82(66.1%) babies were initially put on CPAP, administered intra tracheal surfactant and were continued on CPAP (group B). CPAP was delivered using the Fisher and Paykel CPAP system. Improvement in respiratory distress and successful weaning off from CPAP were taken as response. All neonatal and CPAP variables, associated complications were analysed. Statistical analysis was performed using the SPSS statistics version 18.0 (SPSS Inc., Chicago, IL, USA). Chi-square test, t-test, and Wilcoxon rank-sum test. The results were considered statistically significant at P<0.05. 26(61.9%) of babies from group A and 64(78%) of babies from group B could be successfully weaned off CPAP. The mean gestational ages, male to female ratio, age at administering CPAP, severity of respiratory distress and Fio2 required at the time of admission were comparable in both the groups. The maximum FiO2 required, the maximum PEEP and the duration of CPAP was significantly higher in group A than in group B. There were eight deaths including two babies who required mechanical ventilation in group A compared to 10 deaths in group B. Group A had higher incidence of pulmonary haemorrhage and pneumothorax. CPAP with surfactant administration is more effective than CPAP alone in neonatal RDS.
Authors and Affiliations
Usha Rani Thota, N. Srinivasa Suresh
Keywords
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