Abstract / Summary
Background: One of the most potent technologies to be added to the list of tools of non-invasive modalities in the management of Respiratory distress syndrome is Bubble Continuous Positive Airway Pressure (bCPAP). We want to determine the effectiveness and predictors of bCPAP failure in preterm neonates with respiratory distress syndrome(RDS). Methods: A descriptive longitudinal study was conducted at the Department of Pediatrics, SKBZ CMH, Muzaffarabad, s from November 2025 to April 2026. Non-probability consecutive sampling was used to enroll 89 preterm babies (< 37 weeks) with RDS. Infants who had severe congenital abnormalities or sepsis were not included. The bCPAP protocol was initiated at 4-5 cm and adjusted to 7 cm to maintain SpO2 between 90 and 94. Preventing intubation, mechanical ventilation, or rescue surfactant was considered successful. The data was analyzed using SPSS version 25, and p ≤ 0.05 was deemed significant. Results: Sixty-nine (77.5%) of 89 preterm neonates could successfully be treated with bCPAP while 20 (22.5%) failed to be treated with bCPAP successfully. The mean gestational age was 32.32 ± 2.79 weeks and the mean birth weight was 1718.5 ± 453.2 g. There was no significant difference between sex and treatment outcome (p = 0.913). Likewise, the severity of RDS did not significantly correlate with failure to use of bCPAP (p = 0.888), nor did maternal antenatal comorbidities (p = 0.519). Lower gestational age and lower birth weight were significantly related to failure of bCPAP; sex and severity of RDS were not independently predictive of bCPAP failure in the illustrative predictor analysis. Conclusion: In this low-resource setting, bCPAP was successful in providing respiratory support in about three-fourth of the preterm neonates with RDS. The relationships of treatment failure with neonatal maturity and birth weight were potentially but not definitely associated