Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 1 , ISSUE 1 ( January-June, 2012 ) > List of Articles

Original Article

Noninvasive respiratory support in the preterm neonate with hyaline membrane disease: Bubble CPAP vs Conventional CPAP - A randomised controlled trial

Keywords : Neonates, Hyaline membrane disease, Mechanical Ventilation, Continuous positive airway pressure

Citation Information : Noninvasive respiratory support in the preterm neonate with hyaline membrane disease: Bubble CPAP vs Conventional CPAP - A randomised controlled trial. Indian J Respir Care 2012; 1 (1):42-46.

DOI: 10.5005/ijrc-1-1-42

License: NA

Published Online: 01-12-2022

Copyright Statement:  NA


Background: Continuous Positive Airway Pressure (CPAP) is a noninvasive, gentle method of providing respiratory support to spontaneously breathing neonates. Objective: To compare the effectiveness of bubble CPAP (B-CPAP) over conventional CPAP (C-CPAP) in view of improvement in the severity of respiratory distress in preterm neonates with hyaline membrane disease (HMD). Methods: The targeted populations were all preterm and late preterm neonates admitted in neonatal intensive care unit (NICU) with HMD and respiratory distress, requiring noninvasive ventilation. Neonates who met the inclusion criteria were randomly allocated to either B-CPAP or C-CPAP using random table method. CPAP was started at the earliest signs of respiratory distress and postextubation. Result: Respiratory distress was assessed before and after initiation of CPAP based on Downe's score. The decrease in Downes score was statistically significant in the B-CPAP group compared to C-CPAP group. Primary CPAP failure was 23% (7/30) in the B-CPAP group compared to 10% in the C-CPAP group (3/30) (p = 0.16). The number of days on CPAP, oxygen therapy and NICU stay showed no significant difference. Complications of CPAP were not significantly different. Conclusions: B-CPAP is as effective as C-CPAP in improving respiratory distress. However, CPAP failure rates are higher in B-CPAP group with preterm of extreme low birth weight babies (<1000 g). B-CPAP is one of the most effective and economical mode of noninvasive respiratory support for preterm neonates with HMD.

  1. Courtney SE, Barrington K.J. Continuous positive pressure airway pressure and noninvasive ventilation. Clin Perinatol 2007; 34:73.
  2. Miller MJ, DiFiOre JM, Strohl KP and Martin RJ. Effects of nasal CPAP on supraglottic and total pulmonary resistance in preterm infants. J Appl Physiol 1990; 68: 141–6.
  3. Lee KS, Dunn MS, Fenwick M, Shennan AT. A comparison of underwater bubble continuous positive airway pressure with ventilator-derived continuous positive airway pressure in preterm neonates ready for extubation. Biol Neonate 1998; 73:69–75.
  4. Urs PS, Khan F and Maiya PP. Bubble CPAP - A primary respiratory support for respiratory distress syndrome in newborns. Indian Pediatr 2009; 46:409–11.
  5. Sandri F, Ancora G, Lanzoni A, Tagliabue P, Colnaghi M, Ventura M. Prophylactic nasal continuous positive airway pressure in new borns of 23-31 weeks gestation: multicentre randomized controlled clinical trial. Arch Dis Child Fetal Neonatal Ed 2004; 89:394–8.
  6. Boo NY, Zuraidah AL, Lim NL, Zulfirqar MA. Predictors of failure on nasal continuous positive airway pressure in treatment of preterm infants with respiratory distress syndrome. J Trop Pediatr 2000; 46:172–5.
  7. Liptsen E, Aghai ZH, Pyon KH et. al. Work of breathing during nasal continuous airway pressure in preterm infants: A comparison of bubble vs variable flow devices. J Perinatol 2005; 25:435–8.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.