Abstract Ref Number = APCP1039
RISK FACTOR OF CONTINUOUS POSITIVE AIRWAY PRESSURE FAILURE IN THE MANAGEMENT OF RESPIRATORY DISTRESS SYNDROME IN PRETERM INFANT
Rika Hapsari,Mahendra Tri Arif,Kartika Darma Handayani,Dina Angelika,Martono Tri Utomo,Risa Etika,Agus Harianto
Departement of Child Health Faculty of Medicine Universitas Airlangga RSUD Dr Soetomo Surabaya Indonesia
Background : Respiratory distress syndrome (RDS) is the common cause of respiratory distress in preterm infants. Deficiency of surfactant is one of the most important factors cause to RDS. Continuous Positive Airway Pressure (CPAP) is a non-invasive respiratory support option to avoid harmful effects of positive pressure ventilation. The aim of this study is to determine the risk factors of CPAP failure in the management of RDS in preterm infant less than 32 weeks of gestation
Material : A retrospective study was done at Neonatal Intensive Care Unit (NICU) Dr. Soetomo Hospital from January 2018 to May 2018. Preterm infants less than 32 weeks of gestation and using CPAP in the management of RDS were included. Data was collected from medical record such as gestational age, birth weight, and prenatal history. Primary outcome was CPAP failure and secondary outcome were evaluated. CPAP failure was defined as SpO2<88% on FiO2>60% for more than 30 minutes with requirement of CPAP >8 cms of H2O. Statistical analysis using Chi-square test with P<0.05 was considered significant.
Results : A total of 98 preterm infants was involved, 38(38.3%) were male and 60(61.2%) were female. As many as 46 (47%) infants experienced CPAP failure and the mortality was 41.8%. Surfactant was administered in 15.2% infants. The complication of CPAP such as nasal trauma occurred in 30.6%, necrotizing enterocolitis 9.2%, bronchopulmonary dysplasia 5.1%, pulmonary hemorrhage 1% and CPAP belly 1%. No case of intraventricular hemorrhage was reported. The significant risk factors of CPAP failure were premature rupture of the membrane more than 18 hours (OR 3.76, CI 95% 1.52 to 9.29, P=0.004) and oligohydramnios (OR 7.91, CI 95% 1.01 to 61.92, P=0.024).
Conclusions : Premature rupture of the membrane and oligohydramnios are the risk factors of CPAP failure in preterm infant
Keywords: continuous positive airway pressure respiratory distress syndrome preterm infant