Zeeshan Ahmed, Syed Awais-ul Hassan Shah, Umer Nawaz Khan, Fahim Ahmed Subhani.
Use of indigenously Designed Nasal Bubble Continuous Positive Airway Pressure (NA-CPAP) in Neonates with Respiratory Distress-Experience From a Military Hospital.
Pak Armed Forces Med J Jan ;66(5):645-50.

Objective: to study the efficacy and safety of an indigenously designed low cost nasal bubble continuous positive airway pressure (NB-CPAP) in neonates admitted with respiratory distress. Study Design: a descriptive study. Place and Duration of Study: Combined Military Hospital (CMH), Peshawar from Jan 2014 to May 2014. Material and Methods: Fifty neonates who developed respiratory distress within 6 hours of life were placed on an indigenous NB-CPAP device (costing 220 PKR) and evaluated for gestational age, weight, indications, duration on NB-CPAP, pre-defined outcomes and complications. Results: a total of 50 consecutive patients with respiratory distress were placed on NB-CPAP. Male to Female ratio was 2.3:1. Mean weight was 2365.85 ± 704 grams and mean gestational age was 35.41 ± 2.9 weeks. indications for applying NB-CPAP were transient tachypnea of the newborn (TTN, 52%) and respiratory distress syndrome (RDS, 44%). Most common complications were abdominal distension (15.6%) and pulmonary hemorrhage (6%). Out of 50 infants placed on NB-CPAP, 35 (70%) were managed on NB-CPAP alone while 15 (30%) needed mechanical ventilation following a trial of NB-CPAP. Conclusion: in 70% of babies invasive mechanical ventilation was avoided using NB-CPAP.

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