NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN THE TREATMENT OF NEONATAL RESPIRATORY-DISTRESS SYNDROME

Background.- Early treatment with nasal continuous positive airway pre ssure (CPAP) in newborns with respiratory distress syndrome is useful, by recruiting alveoli and restoring the functional residual capacity. Population and methods.- Nasal CPAP was supplied by the Infant Flow D river (Electro Medical Equipment). From 15 June 1994 to 15 December 19 94, 42 neonates received nasal CPAP. Their mean birthweight and gestat ional age were 1511 +/- 411 g and 30.9 +/- 2.5 weeks, respectively. Fi fteen infants had been ventilated for hyaline membrane disease and nas al CPAP was applied immediately after extubation. In the other 27 infa nts, nasal CPAP was given soon after birth (respiratory distress syndr ome: 20 neonates; apneic spells: seven neonates). Results.- Three infa nts needed subsequent mechanical ventilation because of the severity o f the disease (one had spontaneous pneumothorax); four infants receive d exogenous surfactant (Curosurf(R), one single dose) within a brief p eriod of mechanical ventilation (30-45 min). There were no failure of extubation, and no intracranial lesions. Excess of pharyngeal secretio n and abdominal distension were common. Conclusion.- Early treatment w ith nasal CPAP reduces the need for mechanical ventilation. Furthermor e, surfactant therapy required by a moderate to severe disease is poss ible with a rather short period of artificial ventilation.