Bubble CPAP versus ventilator CPAP in preterm neonates with early onset respiratory distress--a randomized controlled trial

J Trop Pediatr. 2013 Apr;59(2):113-9. doi: 10.1093/tropej/fms061. Epub 2013 Jan 9.


Bubble continuous positive airway pressure (BCPAP) is a low cost nasal CPAP delivery system with potential benefits to developing nations.

Objective: To compare the efficacy and safety of BCPAP with ventilator-derived CPAP (VCPAP) in preterm neonates with respiratory distress.

Methods: In a randomized controlled trial, preterm neonates with Silverman-Anderson score ≥ 4 and oxygen requirement >30% within first 6 h of life were randomly allocated to BCPAP or VCPAP. Proportion of neonates with success or failure was compared.

Results: In all, 47 of 57 (82.5%) neonates from BCPAP group and 36 of 57 (63.2%) neonates from the VCPAP group completed CPAP successfully (p = 0.03). Neonates who failed CPAP had higher Silverman-Anderson score (p < 0.01), lower arterial to alveolar oxygenation ratio (p < 0.05) and needed surfactant more frequently (p < 0.01).

Conclusion: BCPAP has higher success rate than VCPAP for managing preterm neonates with early onset respiratory distress, with comparable safety.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Continuous Positive Airway Pressure / instrumentation*
  • Continuous Positive Airway Pressure / methods*
  • Female
  • Gestational Age
  • Humans
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Oxygen Inhalation Therapy / economics
  • Oxygen Inhalation Therapy / instrumentation*
  • Respiratory Distress Syndrome, Newborn / mortality
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Survival Rate
  • Treatment Outcome
  • Ventilator Weaning