Online ISSN: 2515-8260

Use of Early Nasal Continuous Positive Airway Pressure in preterm Neonates with Hyaline Membrane Disease

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Dr. Rakesh Kumar

Abstract

Background & Objective: Mechanical ventilation is the standard treatment for hyaline membrane disease (HMD) and has increased neonatal surval. However this increased survive has come at the expense of incrected morbindity in the form of chronic lug disease, langer duration of hospitals stay and at the cost of expensive technology. Alternate form of respiratory support is early nasal CPAP. Hence present study aims at managing increasing number of preterm babies with HMD with a non-invasive approach in the form of early nasal CPAP. Methods: 50 babies of 28-34 weeks gestational age admitted in neonatal ICU of pediatrics Department at Patna Medical collage & hospital, Patna with clinical diagnosis of HMD, requiring respiratory support were treated with early nasal CPAP and studied prospectively from 01.12.2019 to 30.11.2020. Statistical analysis: Chi-square and other appropriate tests. Results: We found a success rate of 80% in babies with HMD, who were managed with early nasal CPAP alone. Remaining 20% needed intubation and higher mode of ventilation. Mild and moderate grade HMD were effectively managed with early nasal CPAP (P<0.05). It was also found to be effective in babies of mothers who have received antenatal steroids (P<0.05). Conclusion: Prematurity is the commonest predisposing cause for HMD. Early nasal CPAP is safe, inexpensive and effective means of respiratory support in HMD. it is useful in mild and moderate grade disease. It may not be a replacement for assisted ventilation in severe disease. It is also found to be effective in abies of mothers who have received antenatal steroids.

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