Amjad Iqbal, Talal Waqar, Eel Safdar C Aqeel, Tehreem Iqbal.
Experience of nasal continuous positive airway pressure (CPAP) by infant flow driver in a neonatal unit of a developing country.
Pak Armed Forces Med J Jan ;64(1):75-9.

Objective: To study the safety and efficacy of nasal continuous positive airways pressure by infant flow driver in neonates admitted with respiratory problems. Study Design: Quasi-experimental study. Place and Duration of Study: This study was conducted at CMH Lahore from April 2012 to March 2013. Subjects and Methods: All infants who were treated with nasal continuous positive airway pressure (nCPAP) for various indications at neonatal intensive care unit (NICU) of CMH Lahore were evaluated for gestational age, weight, gender, indications and duration on nCPAP, pre-defined outcomes, complications and length of hospital stay. Efficacy was defined as the ability to manage an infant on nCPAP alone thus avoiding the need for mechanical ventilation. Results: During the study period, 343 neonates were admitted in NICU. Forty five neonates were placed on nCPAP. Mean gestational age was 33.85 ± 3 weeks. Mean weight was 2043 ± 770 grams. Main indications for applying nCPAP were respiratory distress syndrome (48.9%) and neonatal pneumonia (17.8%). Most common complication was abdominal distension (6.7%). Out of 45 infants placed on nCPAP, 32 (71.1%) were managed on nCPAP alone while 13 (28.9%) needed mechanical ventilation after nCPAP failure. Conclusion: Nasal CPAP by an infant flow driver is a useful method to manage respiratory distress in neonates. It reduces the need for mechanical ventilation and can be used as first line respiratory support before mechanical ventilation.

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