Clinical outcomes of bubble continuous positive airway pressure compared to indigenous continuous positive airway pressure in preterm neonates with respiratory distress

Background: Respiratory distress is a major cause of neonatal morbidity and mortality, especially in preterm infants. Continuous positive airway pressure (CPAP) is a widely used non-invasive respiratory support. However, the cost of conventional bubble CPAP (B-CPAP) systems limits their availability in resource-constrained settings. Aims and Objectives: This study aimed to compare the effectiveness and safety of indigenous CPAP (I-CPAP) versus B-CPAP in preterm neonates with respiratory distress. Materials and Methods: A randomized controlled trial was conducted involving 82 preterm neonates (28–<37 weeks gestation) with respiratory distress syndrome. Participants were randomized into two groups: I-CPAP (n=41) and B-CPAP (n=41). The primary outcomes were CPAP failure, survival rates, and complications. Data were analyzed using the Statistical Package for the Social Sciences version 22.0, with P<0.05 considered statistically significant. Results: The demographic characteristics were comparable between the groups. CPAP failure requiring mechanical ventilation was significantly higher in the I-CPAP group (43.90%) compared to the B-CPAP group (21.95%) (P=0.034). Survival rates were similar between groups (I-CPAP: 75.7% and B-CPAP: 72.9%). Complications such as nasal septal injury (P=0.045), skin erosion (P=0.007), dislodgement (P=0.040), and abdominal distension (P=0.023) were significantly higher in the B-CPAP group. Conclusion: I-CPAP demonstrated comparable effectiveness to B-CPAP in managing respiratory distress in preterm neonates, with fewer complications but a higher need for mechanical ventilation. Given its low cost and ease of assembly, I-CPAP can be a viable alternative in resource-limited settings.