About CPAP all are true except:
Correct Answer: Staed with Fi02 50 to 60 percent
Description: B. i.e. Staed with Fi0250-60% (Nasal CPAP or intubation at bih for very preterm infants. The new England journal of medicine Feb 08 vol 358: 700 - 708 nuber 07) Bronchopulmonary dysplasia is associated with ventilation (intubation) & 02 treatment. Infants who were born at 25 -28 weeks gestation and were breathing spontaneously were treated with nasal continuous positive airway pressure (CPAP) sholy (at 5 minutes) after bih. 50% were subsequently intubated. Infants in CPAP group had a better outcome at 28th day than did those in intubated group (i.e. required significantly lower rate of 02 treatment and underwent fewer days of ventilation) even though the rate of pneumothorae was higher in CPAP group. A CPAP of 8 - 12 cm of water was used to maintain functional residual capacity and for improving lung compliance and oxygenation. The study suggests that staing respiratory suppo with CPAP does not adversely affect, infants even if upto 50% of them subsequently undergo ventilation (intubation), some because of pneumothorax. Ammar et al also showed that 76% of infants < 1.251 kg and 50% of those weighing < 0.751 kg did not need to undergo ventilation (intubation). Previous research suggest that CPAP (nasal) application in preterm infants is associated with benefits in terms of reduced respiratory failure and reduced duration and invasiveness of respiratory suppo; without worsening of other standard measures of neonatal outcome (bronchopulmonary dysplasia & death). Among spontaneously breathing very premature infants, surfactant therapy administered within 10 hour of life along with nasal CPAP decreases the oxygen requirement, need for mechanical ventilation and may prevent chronic lung disease.
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Anaesthesia
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