Journal of Neonatal Biology

Survival of preterms with bubble CPAP in a limited resource setting without ABG, surfactant and ventilator

20^th International Conference on Neonatology and Perinatology

December 04-06, 2017 | Madrid, Spain

Yadaiah Damera

District Govt. Hospital-Nalgonda, India

Scientific Tracks Abstracts: J Neonatal Biol

Abstract:

Background: To reduce NMR, GOI is strengthening FBNC through setting up SNCUs. Bubble CPAP for management of RD in preterms was established at SNCU, DH, Nalgonda by MOH, as a Pilot project. Objective: To evaluate the feasibility, safety and efficacy of bubble CPAP in preterms with RD without ABG, surfactant and ventilator. Methods: This is a prospective observational study. Preterms with RD, a Silverman score of > 5 were subjected to bubble CPAP. A rule of 5 was used for all neonates. The maximum pressure used was 7 cms. FiO2 was adjusted to maintain SpO2 between 87-93%. Flow was titrated to maintain continuous bubbling in the bubble chamber. Those infants in whom RD did not resolve with bubble CPAP were referred, as no back up ventilation was available in the unit. Surfactant was not given to any of the infants, no ABG available. Bedside X-ray was done for all babies. Results: From Aug 2013 to Dec 2016, a total of 200 preterm babies with RD were supported with Bubble CPAP. The mean BW of the babies was 1.35±0.49 kg. 120 (60%) infants were male and 80 (40%) female. In 134 (72%) infants the age of starting CPAP was < 6 HOL. In 164 (82%) infants the maximum pressure used was 5 cm of H2O. The mean duration of CPAP was 61.7±19 hours. 170 infants (85%) were successfully discharged. 5 infants were referred to a tertiary care for ventilation. 1 infant had pneumothorax. Conclusions: Early bubble CPAP for RD in preterm babies is feasible, safe and effective at a SNCU in the district hospital. 85% of infants survived. No significant nasal trauma. Use of surfactant was reduced. The incidence of pneumothorax was very less.

Biography :

Yadaiah Damera is working as a Consultant Paediatrician at DH, Nalgonda since 23 years and in SNCU from 2008 as Civil Surgeon, HOD; instrumental in establishing 1st SNCU in India, 1st level 2 unit to get accreditation by NNF. He is working to strengthen the FBNC in India to reduce NMR and discharged 8000 babies till date; smallest baby discharged 650 gms, 28 wk GA, 1st of its kind from dist. Hospital. His areas of interest include: Bubble CPAP, KMC, ROP screening, Follow up NICU graduates and Presented research papers on CPAP, KMC and ROP.