Continuous Positive Airway Pressure in Preterm Neonates: An Update of Current Evidence and Implications for Developing Countries.
Loading...
Date
2015-04
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Context: Continuous Positive Airway Pressure (CPAP) is a cost-effective and minimal invasive respiratory support for the newborn.
Objective: To review the evidence related to various aspects of CPAP usage and its applicability for developing countries.
Evidence Acquisition: We conducted a literature search on PubMed, CENTRAL, and Cochrane Database of Systematic Reviews using
the terms ‘CPAP’ OR ‘continuous positive airway pressure’ OR, non-invasive ventilation’ AND ‘newborn’ OR ‘neonate’ OR ‘infant’. We
also searched the reference lists from the above articles and of review articles. Extracted manuscripts and reviews were analyzed and
results related to various aspects of CPAP usage were summarized in narrative form.
Results: Early use of CPAP with early rescue surfactant (InSurE) is the ideal approach for management of respiratory distress syndrome
in preterm and extremely preterm infants. Delivery room CPAP is feasible and reduces the need for surfactant and mechanical ventilation
by nearly 50%. Prophylactic surfactant for extreme preterms should be discouraged. Heated humidified high flow nasal cannula is best
utilized for post-extubation respiratory support. The search for ideal interface still continues and binasal prongs or nasal masks are the
good contenders. Evidence on the ideal CPAP delivery is still inconclusive.
Conclusions: CPAP, if used early and judiciously, is an effective intervention and need immediate scaling-up in resource-limited settings.
Future research should focus on the ideal interface and the CPAP delivery methods.
Description
Keywords
Continuous positive airway pressure, Mechanical ventilation, Noninvasive ventilation, Neonate
Citation
Gupta Neeraj, Saini Shiv Sajan, Murki Srinivas, Kumar Praveen, Deorari Ashok. Continuous Positive Airway Pressure in Preterm Neonates: An Update of Current Evidence and Implications for Developing Countries. Indian Pediatrics. 2015 Apr; 52(4): 319-320.