Bubble CPAP therapy for neonatal respiratory distress in level III neonatal unit in Amman, Jordan: a prospective observational study

Abstract

Manar Al-lawama,1 Haitham Alkhatib,1 Zaid Wakileh,1 Randa Elqaisi,1 Ghada AlMassad,1 Eman Badran,1 Tyler Hartman2 1Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan; 2Pediatric department, Geisel School of Medicine, Dartmouth University, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA Purpose: Bubble continuous positive airway pressure (bCPAP), a noninvasive respiratory support modality used to manage newborns with respiratory distress, provides continuous pressure that helps prevent derecruitment of alveoli, increasing the lungs’ functional residual capacity, and thus decreasing the work of breathing. bCPAP can be used to manage various respiratory conditions in the newborn. In this prospective study, we describe our experience using bCPAP therapy as the primary respiratory support in a level III neonatal unit in Amman, Jordan. In addition to reporting therapeutic indications, durations, and side effects, we aimed to identify areas requiring improvement in bCPAP therapy in our population. Patients and methods: This prospective observational study investigated the usage of bCPAP in the management of respiratory distress in newborns admitted to a Jordan University Hospital in Amman. The newborns were followed until discharge. The patients’ demographic and clinical data were recorded. Results: A total of 143 babies (mean gestational age, 36±2.7 weeks; mean birth weight, 2,770±1,800 g) were included. All received bCPAP as the primary respiratory support. The most common underlying cause of respiratory distress was transient tachypnea of the newborn (42%), followed by prolonged respiratory transition (34%). The therapy success rate was 93.7%; only nine infants failed bCPAP. The most common side effect was physical facial injury. Conclusion: The use of neonatal bCPAP therapy is well established in Jordan University Hospital. The area of potential improvement was the low rate of bCPAP use as a primary respiratory support in extremely premature infants. Keywords: developing countries, transient tachypnea of the newborn, respiratory distress syndrome, postnatal adaptation

Keywords

• developing countries
• transient tachypnea of the newborn
• respiratory distress syndrome
• postnatal adaptation