Is nCPAP of value in extreme preterms with no access to neonatal intensive care?

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dc.contributor.authorPieper C.H.
dc.contributor.authorSmith J.
dc.contributor.authorMaree D.
dc.contributor.authorPohl F.C.
dc.date.accessioned2011-05-15T16:17:12Z
dc.date.available2011-05-15T16:17:12Z
dc.date.issued2003
dc.description.abstractThis prospective study was undertaken to investigate the efficacy of nasal continuous positive airway pressure (nCPAP) in a group of extremely small infants denied access to a neonatal intensive care unit (NICU) in South Africa. Consecutive infants weighing less than 1200 g and/or of a gestational age below 28 weeks admitted to the neonatal ward with respiratory distress syndrome (RDS), and who were refused admission to the NICU, received either nCPAP (Infant Flow System E.M.E., UK) of headbox oxygen. Of 22 infants, 11 infants were included in the treatment group (nCPAP) and 10 in the control group. Within the first 24 h, two infants (18 per cent) in the nCPAP group and eight infants (80 per cent) in the control group died (p = 0.007) (survival OR = 18; RR = 4.09). A statistically significant improvement in the arterial-alveolar (a/A) oxygen ratio occurred in the nCPAP group between postnatal day 1 and day 3 of life (0.17 vs. 0.36; p < 0.005). Neonatal complications occurred in six (55 per cent) infants who survived the first 24 h of life. Eighty per cent of the infants with intraventricular haemorrhage (IVH) died, as well as all the infants who were born before arrival at the hospital. At the time of discharge from hospital, 45 per cent (five infants) in the nCPAP group survived vs. 20 per cent (two infants) in the control group. The neurodevelopmental outcome of six of the surviving seven infants were evaluated at 1 year of corrected age. The neurodevelopmental outcome as assessed by the Griffith Score was within normal limits in all infants. One infant has sensorineural deafness and one is deaf and has a possible mild spastic diplegia (both in the treatment group). We conclude that nCPAP significantly improves the short-term survival of very low birth-weight (VLBW) infants with moderate to severe respiratory distress syndrome who could not be admitted to intensive care. nCPAP significantly improves the a/A oxygen ratio between day 1 and day 3 of life.
dc.description.versionArticle
dc.identifier.citationJournal of Tropical Pediatrics
dc.identifier.citation49
dc.identifier.citation3
dc.identifier.issn01426338
dc.identifier.other10.1093/tropej/49.3.148
dc.identifier.urihttp://hdl.handle.net/10019.1/14117
dc.subjectoxygen
dc.subjectage
dc.subjectarticle
dc.subjectbrain hemorrhage
dc.subjectclinical article
dc.subjectcontrolled study
dc.subjectdeath
dc.subjectdisease severity
dc.subjectfemale
dc.subjectgestational age
dc.subjecthealth care access
dc.subjecthearing impairment
dc.subjecthospital admission
dc.subjecthospital discharge
dc.subjecthuman
dc.subjectinfant
dc.subjectlung alveolus
dc.subjectlung artery
dc.subjectmale
dc.subjectneonatal respiratory distress syndrome
dc.subjectnervous system development
dc.subjectnewborn intensive care
dc.subjectoxygen therapy
dc.subjectperception deafness
dc.subjectpositive end expiratory pressure
dc.subjectprematurity
dc.subjectprospective study
dc.subjectscoring system
dc.subjectSouth Africa
dc.subjectspasticity
dc.subjectstatistical analysis
dc.subjectsurvival
dc.subjecttreatment outcome
dc.subjectvery low birth weight
dc.subjectward
dc.subjectAdministration, Intranasal
dc.subjectCase-Control Studies
dc.subjectFemale
dc.subjectHumans
dc.subjectInfant, Newborn
dc.subjectInfant, Premature
dc.subjectInfant, Very Low Birth Weight
dc.subjectIntensive Care Units, Neonatal
dc.subjectMale
dc.subjectOxygen Inhalation Therapy
dc.subjectPositive-Pressure Respiration
dc.subjectProspective Studies
dc.subjectRespiratory Distress Syndrome, Newborn
dc.subjectSouth Africa
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.titleIs nCPAP of value in extreme preterms with no access to neonatal intensive care?
dc.typeArticle
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