Early Nasal CPAP treatment in premature neonates

Respiratory distress syndrome (RDS) is a major cause of mortality among premature neonates. The present study was conducted to find out whether early nasal CPAP therapy could eliminate the need for mechanical ventilation in premature neonates with RDS.

For this clinical trial, premature neonates with RDS during the first 6 hours following the delivery were assigned in either case or control group. Case group received early treatment with nasal CPAP, however, standard treatments were applied for controls based on arterial blood gas analysis.

Totally, 25 cases and 22 controls with the mean gestational age of 31.3±2.6 weeks and weight of 1621±540gr. Totally, 68% of controls versus 40.9% of cases died (p=0.06). However, 80% of controls and 36.4% of cases required mechanical ventilation (p=0.006) that lasted averagely 2.9±2.6 days for controls and 0.68±1.3 days for cases (p=0.0009). Surfactant was injected in 48% of controls and 9.1% of cases (p=0.009). Finally, pneumothorax occurrence, oxygen therapy, and duration of hospitalization in NICU did not significantly differ between groups.

Early therapy with nasal CPAP could eliminate the need for mechanical ventilation, and surfactant in premature neonates with RDS. Thus, application of nasal CPAP in centers lack NICU and respirator is strongly suggested.