Outcomes of neonates treated with continous positive airway pressure at the university teaching hospital neonatal intensive care unit, Lusaka, Zambia from 1st october 2015 to 31st October 2016.

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Fundanga, Chailunga Mabo
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The University of Zambia.
Severe respiratory distress is a common and serious complication in the newborn which may be due to premature birth, neonatal pneumonia and neonatal sepsis, accounting for over one-half of all neonatal deaths globally. Nasal continuous positive airway pressure (CPAP) is a noninvasive form of respiratory assistance that has been used to support spontaneously breathing infants with lung disease. The use of CPAP decreases the need for invasive mechanical ventilation and the combined outcome of death or bronchopulmonary dysplasia (BPD). This was a non-randomized convenience sample study to determine the efficacy of a low-cost bCPAP system in treating newborns with severe respiratory distress in the NICU at the UTH in Lusaka, Zambia. 206 files of Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled the inclusion criteria were analyzed using IBM SPSS version 21.0. A greater proportion of the neonates, 145/206 (70.4%) were female compared to 46/206 (22.3%) male. The mean birth weight was 2.1 kg (SD = 1.01). There were 72/206 (35%) neonates with LBW, 69/206 (33.5%) with VLBW, and 65/206 (31.6%) were Term. The mean Apgar at 5 minutes 7.0 (SD = 1.60).There were 47/206 (22.8%) neonates with positive culture results. The mean RR at initial assessment was 71.3 (SD = 8.11).The mean SpO2 at initial assessment was 90.1 (SD = 2.79) and mean SpO2 follow-up was 96.6 (SD = 1.67. The most common sign of respiratory distress was grunting with 174/206 (84.5%) of the neonates, followed by nasal flaring with 149/206 (72.3%) and recessions 140/206 (68%). BCPAP can be safely and successfully administered in Zambian neonates presenting with signs of severe respiratory distress. Since most health care facilities do not have the capabilities to ventilate, this is an optimal alternative.
Thesis of Master of Medicine in Paediatrics and Child Health.