A simple, low-cost bubble CPAP system for use in the delivery room and during transport to the NICU for infants with respiratory distress: A feasibility study.

BackgroundTo assess the feasibility and efficacy of Vayu continuous positive airway pressure (vCPAP) for preterm and term infants with respiratory distress in the delivery room.MethodsFeasibility study of infants of any gestational age presenting with respiratory distress defined as a Silverman-Anderson Score (SAS) ≥4 in the delivery room, who were started on vCPAP prior to transfer to the NICU and maintained during transport. Efficacy was assessed by comparing SAS, FiO2, and SpO2 before initiation of vCPAP, 1 min after initiation, and at the time of NICU admission. Secondary outcomes were feasibility accessed by a survey applied to all health care professionals (HCP), and safety (pneumothorax or clinical deterioration). Descriptive analysis and parametric and non-parametric tests were applied (alpha of 5%).Results10 preterm and 10 term infants were initially enrolled, but one term was excluded because of a protocol deviation. The median gestational age was 37.6 ± 1.1 weeks for preterm and 34.2 ± 1.6 weeks for term infants. A significant improvement in SAS from five prior to vCPAP initiation (IQR 4-6) to three 1 min after initiation (IQR 2-4, p < 0.01), to two on NICU admission (IQR 1-3, p < 0.001). No significant differences in FiO2, SpO2, or CPAP pressure over these time periods were identified. Among HCP, ease of use and satisfaction were highlighted. No complications were observed.ConclusionIn neonates with respiratory distress after birth, a clinical improvement was noted after initiation of vCPAP in the DR and during transport to the NICU.