Abstract
Respiratory distress syndrome (RDS) is one of the most common causes of mortality and morbidity in preterm neonates. CPAP, Surfactant and mechanical ventilation have been the main stay management techniques in RDS. The present research aims to study the usefulness of early delivery room CPAP in preterms and its outcome.
Methods: The study was a randomized control clinical trial with 109 neonates. Neonates born between 28 0/7 to 32 6/7 with evidence of RDS were randomized to receive either delivery room CPAP or delayed CPAP.These groups are compared for predefined primary and secondary outcomes.
Results: Mean Birth weight of cases is 1.24 ± 0.17 and in controls is 1.21 ± 0.19.(P=0.489)The Meangestational age of cases is 29.81 ± 1.56 and in controls is 29.81±1.64 (p=1.0). In this study 23(42.59%) preterms among the cases and 29(52.73%) in controls were present on CPAP for 48-72 hrs. Only 11(20.37%) among cases had CPAP requirement beyond 72 hrs (p=0.55). 16(29.63%) cases required mechanical ventilation, Whereas 28(50.91) preterms in the controls needed mechanical ventilation (p=0.0235). 30 neonates were discharged within 14 days among cases and 16 neonates among control groups. 8 neonates stayed in nicu between 15 – 21 days and 15 neonates in control group. 1 neonate stayed beyond 21 days from cases group and 2 neonates from control group (p=0.0231). 15(27.78%) preterms died due to various causes in the study group and 20(36.36%)preterms died in control group(p=0.337).
Conclusions: Early administration of CPAP in the delivery room in preterm neonates developing respiratory distress decreases the need for mechanical ventilation. Early administration of CPAP helps in early discharge from hospital and early recovery. There is no difference in mortality between the two groups indicating there is no significant impact of early labour room CPAP on mortality