Decreasing Chronic Lung Disease Associated with Bubble CPAP Technology: Experience at Five Years.

Introduction: CPAP) is associated with a decreased risk for chronic lung disease (CLD) in preterm neonates. This report examined the effectiveness of adopting CPAP to reduce respiratory complications and medication usage in a community hospital NICU.

Methods: The efficacy of CPAP was assessed by retrospective examination and comparison of 45 neonates who received CPAP and 87 neonates who received conventional ventilation only. Data on medication usage were also collected and analyzed.

Results: After introduction of the CPAP protocol, the median number of days on oxygen decreased in the CPAP group compared with the conventional ventilation only group (median = 33 days, IQR = 7.5-66 vs median = 0, IQR = 0-0; < 0.001). The exposure to conventional ventilation decreased in the CPAP group compared with the conventional ventilation only group (median = 18 days, IQR = 5-42.5 vs median = 0, IQR = 0-7; < 0.001). Postimplementation of CPAP revealed decreases in CLD from 26 (30%) in the conventional ventilation only group to 2 (4%) in the CPAP group ( = 0.002); there was also a significant decrease in the use of sedative medications in the CPAP group compared with the conventional ventilation only group (mean = 5.20 doses, SD = 31.97 vs mean = 1.43, SD = 9.98; .001).

Conclusion: The use of CPAP results in significant decreases in the use of conventional ventilation, the risk for CLD, and the need for sedative medication.