TF Wang, D Dang, JZ Liu, JF Du, H Wu

Abstract

Objective: A meta-analysis evaluated bubble continuous positive airway pressure (bCPAP) for respiratory distress and investigated the effectiveness and safety of bCPAP in the management of preterm infants via the rate of continuous positive airway pressure (CPAP) failure, the duration of CPAP, the duration of hospital stay and complications. Methods: Randomised controlled trials which compared bCPAP with continuous flow CPAP or variable flow CPAP on preterm infants were searched in electronic literature databases PubMed^®, Embase^®, Web of Science and Cochrane Library. The CPAP failure rate and incidence of complications was measured by the Risk Ratio (RR) with 95% confidence intervals (CI). The duration of CPAP (hr) and hospital stay (d) was measured by the mean difference (MD) with 95% CI. Results: A total of 196 studies were identified, and 7 citations (involving 566 participants) were included finally. The 5 studies on CPAP failure rate had a pooled RR of 0.61 (95% CI: 0.39, 0.96). Four studies on duration of hospital stay showed a MD of -3.95(95%CI: -4.49, -3.41). Four studies on nasal trauma showed a RR of 2.69 (95% CI: 1.36, 5.33). Other complications were comparable in both groups. Conclusion: Bubble CPAP is as effective as the other forms of CPAP in preterm infants with respiratory distress. It reduced the CPAP failure rate and the length of hospital stay; however, it was at higher risk of nasal trauma.