title: The use of continuous positive airway pressure in preterm babies with respiratory distress syndrome: a report from Baghdad, Iraq.
abstract: OBJECTIVE
  To study maternal and neonatal risk factors related to outcome of preterm babies with respiratory distress syndrome (RDS) on Continuous Positive Airway Pressure (CPAP) in a tertiary Iraqi NICU.
  
  
  METHODS
  A prospective case study carried out from January 5, 2011 to January 5, 2012, on 70 preterm neonates with RDS who were started on CPAP. Maternal and infant variables of preterm babies with successful or failed CPAP therapy were compared.
  
  
  RESULTS
  Seventy neonates, 44 (63%) males and 26 (37%) females were included. Mean (SD) gestation was 32.8 (2.8) weeks and mean (SD) birth weight was 1860 (656) g. Thirty-seven (52.9%) babies failed CPAP, of them 29 (78.3%) were started on mechanical ventilation. The variables associated with failure of CPAP were: Birth weight ≤1500 g, gestational age ≤30 weeks, white out on the chest X-ray, FiO2 ≥50% at 20 min of CPAP, PEEP ≥5.5 cm H2O. Mortality rates were 94.6% in CPAP failures versus 5.4% in CPAP successes (p = 0.001). In infants surviving till discharge, duration of hospital stay was longer in babies who were CPAP successes (9.6 ± 3.7 versus 3.0 ± 2.7 days, p = 0.001).
  
  
  CONCLUSIONS
  Gestational age, birth weight, whiteout chest X-ray, and FiO2 are important predictive values for success of CPAP therapy. A larger prospective multicenter controlled trial is needed to determine the benefits and risks of CPAP and predictors of its failure in our setting. Our results may be useful for others practicing in similar settings as us.
authors.affiliation: Department of Pediatrics, College of Medicine, Baghdad University , Baghdad , Iraq .
authors.forename: Numan Nafie
authors.initials: NN
authors.lastname: Hameed
authors.forename: Ra'id Khalil
authors.initials: RK
authors.lastname: Abdul Jaleel
authors.forename: Ola Didrik
authors.initials: OD
authors.lastname: Saugstad
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000209:etiology; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000628:therapy*; D007493:Iraq / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011014:Pneumonia / Q000151:congenital / Q000453:epidemiology / Q000209:etiology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000628:therapy*; D018805:Sepsis / Q000151:congenital / Q000453:epidemiology / Q000209:etiology