A Study to Assess the Outcome of Non-Invasive Bubble CPAP in the Management of Respiratory Distress in Neonates

Introduction: The neonatal period, encompassing the first 28 days of life, is the most critical for a child's survival. Respiratory distress is a major cause of neonatal morbidity and mortality, with neonatal respiratory distress syndrome being the most common aetiology, particularly in preterm infants. Despite advancements in neonatal care, including antenatal corticosteroids and surfactant therapy, respiratory distress remains a significant challenge, necessitating effective and accessible non -invasive respiratory support. Aim and Objectives: This study evaluates the clinical outcomes of neonates managed with bubble continuous positive airway pressure, focusing on its role in reducing respiratory distress severity, minimising NICU stay, and identifying factors influencing treatment success. Methodology: This is a prospective observational study which was conducted at the Neonatal Intensive Care Unit of our institute from May 2023 to April 2025. The study included 150 neonates with moderate respiratory distress, defined by a Downes' Score of 4 to 6 and oxygen saturation (SpO) below 90% despite supplemental oxygen. Neonates with severe respiratory distress (Downes' Score >7), major congenital anomalies, or requiring immediate invasive ventilation were excluded. Data collection included maternal and neonatal history, mode of delivery, antenatal steroid administration, respiratory distress severity, and bCPAP response. Neonates were closely monitored, and statistical analysis was performed using SPSS version 20, with p<0.05 considered statistically significant. Results: The study population consisted of 150 neonates, with a male predominance (58.7). Respiratory distress syndrome was the most common diagnosis (70.0%), followed by birth asphyxia (16.0%), meconium aspiration syndrome (12.0%), and congenital pneumonia (2.0%). The Downes' Score strongly predicted respiratory distress severity, with higher scores correlating with increased mechanical ventilation need and prolonged NICU stay. Neonates requiring bCPAP for >24 hours had higher ventilation rates, while those on bCPAP for <12 hours had significantly better outcomes. The overall survival rate was 81.3%, and 18.7% required mechanical ventilation. Conclusion: The study highlights the efficacy of bCPAP as a first -line respiratory support in neonates with moderate respiratory distress. Early initiation of bCPAP, appropriate PEEP settings, and complete antenatal steroid administration significantly improved outcomes, reducing the need for mechanical ventilation and prolonged NICU stay.