Evaluation of early nasal continuous positive airway pressure management in preterm babies / Walaa Mahmoud Taher Hamed ALazamy ; Supervised Mohammed Elsayed Hashem , Hanna Mohamed Abuolghar , Sherif ELanwary Abdelmoneim

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

To evaluate the predictors associated with early failure of nasal CPAP treatment in preterm babies less than 34 weeks gestation. Patient and Methods: We observed 50 neonates initiated immediately or within 6 hours of birth on nasal CPAP for respiratory distress syndrome. CPAP was administered through neopuff starting from delivery room then shifted to NICU on variable flow CPAP using short binasal prongs and nasal mask CPAP.Results: Primary outcomes of the study were success group that included 32 neonates (64%).While CPAP failure group, who required mechanical ventilation after CPAP failure, included 18 neonates (36%). Our result include predictors for early nasal CPAP failure that showed that the gestational age ,body weight, Sever acidosis , initial Fio2 , initial PEEP and PDA in the echo were the best sensitive independent parameters that can predict CPAP failure. Conclusion: Causes of CPAP failure were multifactorial and combining gestational age, birth weight, the initial fraction of inspired oxygen, initial PEEP, Severe acidosis, and PDA allows for a better and more individualized prediction of early nasal continuous positive airway pressure failure in preterm infants less than 34weeks gestation.Further study to include all types of respiratory distress other than RDS that may affect neonates not only preterm and the use of CPAP in their management is recommended

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