Date of Award

9-15-2009

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Respiratory Therapy

First Advisor

Doug Gardenhire - Chair

Second Advisor

Chip Zimmerman

Third Advisor

Lawrence Bryant

Abstract

Bubble CPAP (BCPAP) is used in the neonatal intensive care unit (NICU) as a form of non-invasive ventilation and is commonly employed in neonates demonstrating respiratory distress. BCPAP may be used to avoid the need for intubation and mechanical ventilation thereby reducing lung injury and other morbidities as well as decrease hospital stay. PURPOSE: The purpose of this study is to retrospectively investigate the length of stay on bubble CPAP (BCPAP) considering gestational age, birth weight, and surfactant delivery in the neonatal population born at an urban tertiary high load level three (NICU). METHODS: A retrospective study using existing data from an urban tertiary high load level three NICU was completed. DATA ANALYSIS: Data analysis was performed using SPSS 16.0. Descriptive statistics were run for each variable. Contingency tables were run to determine if gestational age at birth, birth weight, and length of time on BCPAP had significance compared to surfactant delivery. Intercorrelations were run to determine if gestational age at birth, birth weight, and length of time on BCPAP had an effect on each other. Davis conventions were used to analyze the results. RESULTS: Descriptive statistics indicated the mean gestational age at birth to be 32.263 weeks, SD = +2.978, mean neonatal weight to be 1.899 kg, SD = +0.728, and mean length of time on BCPAP to be 124.430 hours, SD = +185.474. Contingency statistics showed a substantial association (reta = 0.562) between the gestational age at birth and surfactant delivery, a very strong association (reta = 1.000) between the birth weight and surfactant delivery, and a very strong association (reta = 0.914) between the length of time the neonate was on BCPAP and surfactant delivery. Pearson product-moment correlation coefficients showed gestational age at birth had a very strong positive association with birth weight (r = 0.811, p < 0.01) and a moderate negative association with length of time on BCPAP (r = -0.439, p < 0.01). Intercorrelations also showed birth weight had a moderate negative association with length of time on BCPAP (r = -0.306, p < 0.01). CONCLUSIONS: The neonate was less likely to receive surfactant if, their gestational age was older at birth, they had a heavier birth weight, and their length of time on BCPCP was shorter. The data also demonstrated that the older the neonate’s gestational age at birth and the heavier the neonatal birth weight equated to a shorter length of time on BCPAP. Lastly the data demonstrated that the heavier the neonate’s birth weight, the shorter length of time on BCPAP.

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