REDUCED NEONATAL MORTALITY DUE TO THE USE OF CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) IN RESPIRATORY DISTRESS SYNDROME (RDS).
EXPERIENCE OF ST. JOHN XXIII HOSPITAL ABER IN OYAM DISTRICT.
Authors: 1Dr. Cephas Caroline Adong, 1Rev. Father Dr. Samuel Okori, 2Dr. Oryem Vincent, 2Akongo Jenifer, 2Muga Babra, 2Dr. Jerry Ictho, 2Dr. Yiga John.
Neonatal intensive care unit (NICU) in Aber hospital serves Oyam district and surrounding areas in order to reduce perinatal and neonatal mortality. RDS, one of the complications of prematurity predominates as the leading cause of death in children less than five years. Worldwide CPAP is an established intervention in RDS management. In September 2019, CPAP was introduced in NICU to improve RDS management. Here we report it’s effect on mortality of neonates due to RDS.
From November 2018 till June 2020, we studied the records of preterm neonates diagnosed with RDS and admitted to NICU in the pre CPAP (n=36) period from November 2018 -August 2019 and the post CPAP (n=65) period from September 2019 till June 2020. CPAP was applied to preterm neonates with RDS when clinically indicated and oxygen cylinder was available. The outcome was noted.
More than 50 % reduction in neonatal mortality due to RDS was realized. A decline in mortality from 66.7% to 27.7% in pre and post CPAP periods respectively
CPAP reduced mortality due to RDS by over 50%. In high-income countries, CPAP strategy markedly improved neonatal survival in addition to surfactant therapy and mechanical ventilation.
CONCLUSION and LESSONS LEARNT.
Introduction of CPAP significantly lowered mortality due to RDS. A further reduction can be realized with timely referral from lower health facilities, steroid administered to mothers with preterm labor, continuous availability of oxygen to supply the machine and exogenous surfactant replacement therapy.