Abstract
The developmental and neurological outcome in infants sustained on head chamber CPAP has yet to be assessed. A pressurized head chamber was used to deliver CPAP to 50 infants with the respiratory-distress syndrome (RDS). Birthweights ranged from 820 gm. to 3880 gm. (mean 2267 gm). CPAP was delivered via plastic head chamber with mean starting pressure of 4.8 cm H2O and mean peak pressure of 5.4 cm H2O. There was a 10% (5/50) incidence of pneumothorax. Other complications such as neck ulcers and hydrocephalus did not develop. Overall survival was 46/50(92.0%). Adequate follow-up has been obtained on 38/46 (82.6%) of surviving infants. Follow-up observations included the Denver Developmental Screening (DDST) and neurological examinations at ages ranging form 6 mo. to 2 yrs. 32/38 (84.2%) had normal DDST and 35/38 (92.%) had normal neurological examinations. 5 of the 6 infants with abnormal DDST were delayed only in gross motor development. 3 of 5 Infants had normal neurological examinations while 2 had mild spasticlty. The sixth infant was meconium stained at birth and had neonatal meningitis. He was delayed in all areas of the DDST and had marked spasticity. Ophthalmological examinations on 14/38 (36.8%) were all normal. Audiological evaluations on 20/39 (52.6%) revealed 17/20 (85%) with normal hearing while 3/20 (15%) had mild conductive hearing loss.
We conclude that head chamber CPAP is an effective means for treating RDS with low morbidity and mortality and minimal associated neurological sequelae.
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Pauly, T., Cunningham, M., Desai, N. et al. DEVELOPMENTAL AND NEUROLOGICAL OUTCOME FOLLOWING TREATMENT WITH HEAD CHAMBER CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP). Pediatr Res 11, 381 (1977). https://doi.org/10.1203/00006450-197704000-00071
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DOI: https://doi.org/10.1203/00006450-197704000-00071