USE OF EARLY CPAP IN PRETERM NEONATES WITH HYALINE MEMBRANE DISEASE

Abstract

Introduction: Hyaline Membrane Disease (HMD) is a major cause of respiratory distress in
preterm neonates due to a deficiency in pulmonary surfactant. Continuous Positive Airway
Pressure (CPAP) serves as an effective non-invasive respiratory support that can reduce the
necessity for invasive ventilation. This study evaluated the efficacy and outcomes of nasal CPAP in preterm neonates with HMD.
Materials & Methods: After receiving IEC approval, a 12-month retrospective and prospective
observational study was conducted. The study involved 50 intramural neonates, aged 28-36 weeks gestation, admitted to the NICU at IMCHRC with clinical and radiological signs of HMD. These neonates were treated with nasal CPAP and categorized into two groups: CPAP success (weaned off CPAP) and CPAP failure (required mechanical ventilation). Statistical analyses compared outcomes between these groups.
Results: Among 227 preterm deliveries, 62 inborn neonates were diagnosed with HMD, and 50
received CPAP within 0-6 hours of birth. CPAP was successful in 82% of cases, while the
remaining 18% required advanced ventilation. The mean CPAP duration was 37.5 ± 15.40 hours for the success group and 9.2 ± 1.56 hours for the failure group. CPAP effectiveness was 100% for mild, 93.10% for moderate, and 46.67% for severe HMD. Furthermore, 90% of those needing ventilation were under 32 weeks gestation.
Conclusion: In developing countries, where prematurity and limited antenatal steroid use increase HMD risk, early nasal CPAP effectively treats mild to moderate HMD but is less effective for severe cases. It offers a safe, cost-effective alternative to invasive ventilation, reducing mechanical ventilation requirements, hospital stays, complications, and mortality.