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Treatment outcomes of bubble-CPAP versus oxygen therapy among preterm babies presenting with respiratory distress syndrome at a tertiary hospital in Tanzania – Randomised Trial

Citation:

Annette Baine1 , M. Mahande2 , R. Olomi1 , B. John2 , R. Philemon1

Publication year:

2019

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Objectives:

We determined the efficacy of bCPAP treatment and its immediate outcomes as compared to oxygen therapy in preterm babies presenting with RDS.

Method:

A randomized control trial, conducted at a tertiary hospital in Tanzania, included all premature babies admitted at the neonatal care unit presenting with signs of RDS. The primary outcome was survival while secondary outcomes were treatment duration, duration of hospital stay and treatment complications

ined the efficacy of bCPAP treatment and its immediate outcomes as compared to oxygen therapy in preterm babies presenting with RDS. Method: A randomized control trial, conducted at a tertiary hospital in Tanzania, included all premature babies admitted at the neonatal care unit presenting with signs of RDS. The primary outcome was survival while secondary outcomes were treatment duration, duration of hospital stay and treatment complications.

Results:

A total of 824 babies were admitted during the study period. Of these, 187 babies were preterm and 48 babies were enrolled and randomized (25 bCPAP vs 23 oxygen). After randomization, 3 babies were excluded leaving 45 babies (22 bCPAP vs 23 oxygen). The overall survival to discharge for all eligible participants was lower as compared to those who adhered to treatment protocol (58.5% vs 62.2%). Babies in the bCPAP grouphad higher survival (17/22; 77.8%) as compared to their counterparts (11/23; 47.8%). Babies treated with bCPAP had 7- fold higher odds of surviving (OR 6.9, 95% CI:1.34 – 35.20) compared to babies receiving oxygen therapy. Babies receiving oxygen therapy had longer mean treatment duration (87±105.9 hours vs 48±37.8 hours).Amongst the survivors, those who received bCPAP experienced a shorter mean duration of hospital stay (19.9±12.2 vs 20.2±10.9 days). Nasal bleeding was commonly observed among babies in the bCPAP group as compared to the oxygen therapy group.

Conclusion:

This study revealed that bCPAP had a 30% significant improvement in survival to discharge and reduced duration for RDS treatment when compared oxygen therapy. Our findings suggest that bCPAP may help in reducing neonatal mortality if rolled out at a large scale with an aim of attaining the global SDG three. This work was supported by THRiVE-2 support, a DELTAS Africa grant # DEL-15-011 from Welcome Trust grant # 107742/Z/15/Z and the UK government.

External link:

https://aasopenresearch.org/documents/2-74

KCRI

An Academic Centre for Evidence Based Health Interventions

Treatment outcomes of bubble-CPAP versus oxygen therapy among preterm babies presenting with respiratory distress syndrome at a tertiary hospital in Tanzania – Randomised Trial