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

causes of mortality & morbidity in preterm neonates.In recent years, use of continuous positive airway pressure (CPAP) has gained immense popularity as the primary mode of respiratory support in these infants. Its use has been associated with reduced need for mechanical ventilation and associated lung injury.Objectives: To evaluate the predictors associated with failure of nasal CPAP treatment in preterm babies. Patient and Methods: We prospectively observed 61 neonates initiated on nasal CPAP for respiratory distress in the first 24 h of life.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 showed that CPAP use was successful in 60.7% of studied case, and failed in 39.3%. the multivariate analysis showed that the chest X ray after CPAP, SBP {u2264} 66, chest X ray before CPAP and apnea were the important predictors for CPAP failure with odds ratio and 95% CI of 0.099 (0.017 {u2013} 0.587), 52.689 (1.715 {u2013} 161.995), 10.678 (1.340 {u2013} 85.105) and 4.427 (1.033 {u2013} 18.458), respectively.Conclusion: there are no clinically adequate predictors for early nasal CPAP failure at time of admission to the NICU. A threshold FiO2, hypercarbia, apnea, poor respiratory efforts, systemic hypotension, Silverman score, bandemia, congenital heart diseases were the most significant associations for CPAP failure

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