[Clinical and laboratorial repercussions of the nasal CPAP in preterm newborns]
OBJECTIVE: Evaluate the efficacy and problems associated with nasal CPAP use. METHODS: 96 preterm newborns needing nasal CPAP either as initial ventilatory support or as weaning from the ventilator were studied prospectively. RESULTS: Nasal CPAP was used in children weighing 480g to 2,450g and corrected gestational age of 24 to 39 weeks. It was indicated in cases of apnea (12.5%), hyaline membrane disease (32.3%), pneumonia (4.2%), transient tachypnea (22%), and weaning from the ventilator (29%). The last indication was more frequent in children with lower weight (p<0.01). The median time in nasal CPAP was 60.3h. After CPAP installation, there was a significant improvement in the respiratory distress that was not shown in the blood gases analysis. The percentage of children with nasal hyperemia, nasal bleeding, abdominal distention and children that could be fed was directly proportional to how long they had been in nasal CPAP. Children weighting </= 1,000g had higher incidence of abdominal distention (p<0.01) and those with weight between 1,500 to 2,500g faced higher difficulty to be maintained on nasal CPAP (p=0.04). Therapeutic success was of 37% for children weighing </=1,000g, 59% for the ones weighing 1,000 to 1,500g, and 83% for those weighing 1,500 to 2,500g. CONCLUSIONS: Nasal CPAP is a good option for ventilatory assistance in preterm babies. It is a safe therapy which in general has only topic complications; it does not prevent patients from being fed during its use. Furthermore, it was successful in 59% of the studied patients. do CPAP nasal.
Rego
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Universidade de São Paulo (USP), SP, Brazil.
Martinez
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