Usefulness of Downe Score as clinical assessment tool and Bubble CPAP as primary respiratory support in neonatal respiratory distress syndrome

Pankaj M Buch, Aarti M Makwana, Dr Rajesh K Chudasama
7.598 2.012


Background: In preterm neonates respiratory distress syndrome (RDS) is one of the common causes of morbidity and mortality. Application of Bubble CPAP has been shown to be beneficial in terms of reduced need of invasive ventilation and prolonged hospital stay in newborns with RDS.
Objective: Present study was conducted to assess the outcome of Bubble CPAP in newborns and usefulness of Downe score in predicting outcome and use as an assessment tool by medical/ nursing staff in resource limited setup.
Method: We conducted this prospective study to evaluate effectiveness of Bubble CPAP as primary mode of respiratory support in resource limited setup of periphery with Downe score used as one of the tool to assess response to treatment. The study was conducted from November 2010 to February 2012 and based on inclusion criteria a total of 75 newborns were enrolled.
Results: CPAP failure was observed in37.3% of preterm babies with RDS. Chest X ray suggestive of severe RDS, Downe score > 6 at 15-20 minutes of starting CPAP and sepsis/pneumonia was significantly associated with CPAP failure and also were independent predictors of outcome. Area under curve (AUC) for Downe score at 15-20 minutes of starting CPAP was 78.5% (95% CI = 67.9 to 89.1)
Conclusion: Bubble CPAP was found to be effective and safe mode of treating mild to moderate RDS and Downe score can be used at periphery to monitor response and to decide about referral in absence of sophisticated test.
Keywords: Bubble CPAP, Downe score, Predictors of CPAP failure


Bubble CPAP, Downe score, Predictors of CPAP failure

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