Nasal prongs versus face mask for continuous positive airway pressure in preterm neonates

Abstract

Respiratory distress syndrome (RDS) is representing the single most important cause of mortality and morbidity in preterm infants.RDS is the most common cause of respiratory failure and requirement for MV in newborn. Continuous positive airway pressure is a technique of respiratory support generating a continuous distending pressure applied to the lung. Oxygen is delivered into the airways under pressure to distend the airways and alveoli, maintain lung volume during expiration, make breathing easier, and improve gas exchange. The present study was done to compare nasal prongs with face mask for delivery of nasal continuous positive airway pressure in preterm neonates. The study included 40 preterm neonates who were admitted to NICU with mild to moderate RDS and required continuous positive pressure ventilation immediately after birth. The studied patients were randomly divided into 2 groups: Group I (mask CPAP) and group II (nasal CPAP), each group included 20 patients. All patients were subjected to detailed history taking, full clinical examination and investigations including; chest x-ray, .complete blood count, CRP and capillary blood gases at the time of enrolment with study. As regards the demographic characteristics of patients with RDS in both groups, no significant differences were found between the two studied groups regarding gestational age, sex, weight, Apgar score and the degree of RD. In our study, there were no statistically significant differences between both groups regarding ventilatory settings. On comparing the clinical outcomes in the present study, there was an evidence of clinical improvement in nasal CPAP group that was reflected by less failure rate, more tolerance (less comfort scale) and less cutaneous sores than in mask CPAP group. None of patients in both studied groups got pneumothorax. There was no significant statistical difference between both study groups regarding mortality.