EFFECTIVENESS OF BUBBLE CPAP IN PRETERM NEONATES ADMITTED IN NICU WITH RDS USING THE DOWNES SCORING

Abstract

Introduction: 

Respiratory Distress Syndrome (RDS) is a leading cause of mortality in preterm neonates. Bubble Continuous Positive Airway Pressure (bCPAP) is a non-invasive, cost-effective respiratory support method endorsed for managing RDS, particularly in resource-limited settings. This study aimed to evaluate the effectiveness of bCPAP in preterm neonates with RDS using the Downes scoring system.

Methods: 

A prospective interventional study was conducted in a tertiary care NICU over six months, involving 150 preterm neonates (<37 weeks gestation) with RDS and a Downes Score of ≥4. All neonates received bCPAP therapy. The primary outcome was the change in Downes Score from baseline to 1-, 6-, 12-, and 24-hours post-initiation. Success was defined as clinical improvement avoiding mechanical ventilation.

Results: 

The mean Downes Score showed a statistically significant reduction from a baseline of 6.2 ± 1.1 to 2.9 ± 0.7 at 24 hours (p < 0.001). bCPAP therapy was successful in 124 neonates (82.6%), while 26 (17.4%) required mechanical ventilation. Complications were minimal, with nasal trauma in 5.3% and pneumothorax in 2.0% of neonates. The overall survival rate at discharge was 92%.

Conclusion: 

Bubble CPAP is a highly effective, safe, and cost-efficient first-line intervention for managing RDS in preterm neonates. It leads to rapid and significant improvement in respiratory distress, a high success rate, and a substantial reduction in the need for mechanical ventilation, making it particularly valuable for neonatal care in resource-limited environments.