Fatima Kaneez, Zulfiqar Sughra, Farooq Ammara, Aziz Musfirah
Kaneez Fatima, FCPS Neonatal Fellow Combined Military Hospital, Rawalpindi, Pakistan.
Sughra Zulfiqar, MRCPCH Assistant professor Paediatrics, Watim Medical College, Rawalpindi, Pakistan.
Pak J Med Sci. 2024 Sep;40(8):1831-1836. doi: 10.12669/pjms.40.8.8753.
This study aimed to assess the efficacy of nasal continuous positive airway pressure (CPAP) in term and preterm neonates with respiratory distress by evaluating successful outcomes, identifying factors contributing to treatment failure, and documenting associated complications.
A comparative cross-sectional study design was employed. The research was conducted at Combined Military Hospital (CMH) Rawalpindi from November 2022 to July 2023. All consecutive neonates admitted during the specified period with respiratory distress requiring CPAP treatment and meeting inclusion criteria were enrolled. Pre- and post-CPAP respiratory distress levels, relevant biochemical markers, as well as mortality and morbidity rates were documented. Both descriptive and inferential statistical analyses were employed.
The mean age of the study cohort was 53.3±85.6 minutes. The average time to initiate CPAP was 82.4 ± 94.7 minutes. Mean gestational age stood at 34.68±2.8 weeks. CPAP was successful in 97% of babies. The low birth weight below 1200grams was the main factor related to failure of CPAP. The mean Downes score decreased from 5.8±1.3 before CPAP to 3.3±1.6 after 12 hours of CPAP and further to 1.85±2 after 24 hours. Significant improvements in Downes score were noted after 24 hours of CPAP usage (p < 0.05) using paired sample T-test.
This study affirms the effectiveness of CPAP in addressing neonatal respiratory distress. The utilization of CPAP emerges as a valuable intervention that not only reduces the requirement for invasive ventilation but also exhibits the potential to alleviate morbidity and mortality rates among neonatal populations.
本研究旨在通过评估成功结局、确定导致治疗失败的因素并记录相关并发症，来评估经鼻持续气道正压通气（CPAP）对足月儿和早产儿呼吸窘迫的疗效。
采用比较性横断面研究设计。该研究于2022年11月至2023年7月在拉瓦尔品第联合军事医院（CMH）进行。纳入在指定期间因呼吸窘迫需要CPAP治疗且符合纳入标准的所有连续入院新生儿。记录CPAP治疗前后的呼吸窘迫水平、相关生化指标以及死亡率和发病率。同时采用描述性和推断性统计分析。
研究队列的平均年龄为53.3±85.6分钟。开始使用CPAP的平均时间为82.4±94.7分钟。平均胎龄为34.68±2.8周。97%的婴儿使用CPAP治疗成功。出生体重低于1200克是与CPAP治疗失败相关的主要因素。Downes评分的平均值从CPAP治疗前的5.8±1.3降至CPAP治疗12小时后的3.3±1.6，并在24小时后进一步降至1.85±2。使用配对样本T检验，在CPAP使用24小时后，Downes评分有显著改善（p<0.05）。
本研究证实了CPAP在解决新生儿呼吸窘迫方面的有效性。CPAP的应用是一种有价值的干预措施，不仅减少了有创通气的需求，而且还具有降低新生儿发病率和死亡率的潜力。
