Bubble CPAP Therapy in Newborns With Respiratory Distress With Its Outcome-A Prospective Observational Study From a Neonatal Intensive Care Unit of Tertiary Care Hospital in Western Nepal.

Background: Respiratory distress is one of the most common reasons for the admission of neonates to the NICU in low and middle-income countries (LMICs) like Nepal, where bubble CPAP therapy is one of the most emerging and first-line treatments. Aims: The aim is to study the various indications of bubble CPAP therapy in neonates with respiratory distress in different clinical conditions, success and failure rates, and outcomes. Methods: A prospective observational study was conducted for 17 months (Oct 2021-Feb 2023) at Universal College of Medical Sciences, Bhairahawa, Nepal, where 90 neonates with respiratory distress were enrolled and kept on bubble CPAP therapy. Various clinical conditions of CPAP use were observed along with success and failure rates. The final outcome was documented as discharge or death occurred. Results: A total of 90 babies with respiratory distress required CPAP therapy, where 53.3% were preterm, 44.4% term, and the rest postterm. About 32.2% of neonates had birth asphyxia, 16.7% had respiratory distress syndrome (RDS), 14.4% of cases had prematurity, and 12.2% had meconium aspiration syndrome. The study found a significant mean difference in Silverman score (in preterms) and Downe's score (in terms) before and after 6 h of CPAP ( Conclusion: Birth asphyxia, respiratory distress, and prematurity were three leading causes of respiratory distress for the initiation of CPAP in the present study.