Browsing by Author "krishna, Y. Sivarama"

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    Outcome of Bubble (CPAP) Continuous Positive Airway Pressure in Neonates with Respiratory Distress and its failure factors.
    (International Society for Contemporary Medical Research, 2019-07) Byram, Sunitha Kumari; krishna, Y. Sivarama; M.S., Raju
    Introduction: Bubble CPAP is an important, simple, noninvasive, and cost effective treatment modality for respiratorydistress in neonates. The aim of our study was to know theoutcome of Bubble CPAP in preterm and term neonatesrequiring respiratory support and to study its failure factors.Material and methods: A retrospective observational studywith Bubble CPAP was done on 100 babies both term andpreterm with respiratory distress requiring for respiratorysupport admitted in NICU of Government General Hospital,Guntur. Monitoring was done clinically, with pulse oximeter,radiologically and with blood gases. Neonates with respiratorydistress secondary to sepsis, necrotizing entero colitis,congenital anomalies like Tetrology of Fallot, cleft lip withcleft palate, congenital diaphragmatic hernia, choanal atresia,who had severe respiratory distress with cardio vascularinstability were excluded in our study.Results: The mean gestational age was 32-34 weeks, birthweight was 1.4 kgs.52% were very low birth weight<1.5kgs. CPAP failure rate was higher in preterm and very lowbirth weight. The most common disease for starting BubbleCPAP was Respiratory Distress Syndrome 56 cases followedby Meconium Aspiration Syndrome 16 cases, congenitalpneumonia, Transient Tachypnea of New Born and BirthAsphyxia. The common complications on CPAP were shock,apnea and nasal damage. Overall failure rate was 36% (36cases). All babies who failed on CPAP were put on mechanicalventilation. Failure among Respiratory Distress Syndromewas about 42%, in Meconium Aspiration Syndrome 31%,congenital pneumonia 35.7%. Higher cases of sepsis andpulmonary hemorrhage were seen in failure group. Overallsurvival rate of the study was 64%(64cases).Conclusion: Bubble Continuous Positive Airway Pressure issafe, effective and easy to use in preterm and term neonateswith mild to moderate Respiratory Distress. The major failurefactors in our study were sepsis, recurrent apnea. The successrate was 64%