Comparison of Bubble Nasal Continuous Positive Airway Pressure (bCPAP) Versus Control in Neonates With Respiratory Distress
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Neonatal Respiratory Distress
- Sponsor
- King Edward Medical University
- Enrollment
- 120
- Locations
- 1
- Primary Endpoint
- Effectiveness of Bubble CPAP determined by improvement in Silvermann Anderson Retraction Score
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
The objective of study is to determine the effectiveness of bubble Continuous Positive Airway Pressure (bCPAP) in neonates presenting with respiratory distress as compared to the control group ( using oxygen via nasal cannula). The effectiveness will be calculated in terms of reduction in Silverman Anderson Retraction Score.
Detailed Description
After approval from the IRB of King Edward Medical University, and taking informed consent from parents of the participants, total of 120 neonates fulfilling inclusion and exclusion criteria will be enrolled and randomly allocated in two groups; group A and group B. All demographic details of participants in both groups be collected. In group A, neonates will be given bCPAP for respiratory support while neonates in group B, will be given nasal oxygen as control group. Neonates in both groups will be followed for 48 hours. The effectiveness will be determined by the reduction in Silverman Anderson Retraction Score (SARS) up to or less than 3, at the end of 48 hours. Data will be collected and analysed.
Investigators
Tehreem Fatima
Tehreem Fatima, Senior Registrar, Children Hospital & ICH Faisalabad.
King Edward Medical University
Eligibility Criteria
Inclusion Criteria
- •Patients having age 28 days of life or younger (Neonates)
- •Gender- both male and female
- •Gestational ages ≥32 weeks
- •Having respiratory distress (as per the operational definition- respiratory rate \>60/min plus any of the following features: grunting, subcostal/intercostal retractions, nasal flaring, inability to maintain spO2 \>90% at room air)
- •Silverman Anderson Retraction Score ≥4
Exclusion Criteria
- •Neonates having gestational age less than 32 weeks
- •Birth weight less than 1.5 kg
- •Neonates having congenital malformations, air leak syndromes, hypoxic ischemic encephalopathy
- •Neonates requiring mechanical ventilation at the time of admission
Outcomes
Primary Outcomes
Effectiveness of Bubble CPAP determined by improvement in Silvermann Anderson Retraction Score
Time Frame: 48 hours since application of intervention
Neonates in both groups will be followed-up for 48 hours. SAR Score will be recorded at 0 and 48 hours. It consists of five components: (1) chest retractions (2) retraction of the lower intercostal muscles (3) xiphoid retractions (4) flaring of nares with inhalation (5) grunting on exhalation. Each of the five factors is graded 0, 1 and 2. The sum of these factors yields the total score; minimum score is '0' and maximum score is '10'. The higher the score, the greater is the severity of respiratory distress. So the severity of respiratory distress can be graded according to the SAR Score as Mild (score 0-3), Moderate (score4-6) and Severe (score 6-10). Effectiveness is recorded as 'positive' in case of reduction in SARS score ≤3. A cut-off of score '3' is taken. So if the score of 3 or less than 3 is achieved with bCPAP or with nasal oxygen after 48 hours of intervention, the intervention is considered to be effective
Secondary Outcomes
- Mean reduction in SAR Score(48 hours)
- Difference in mean reduction(48 hours)