Uso da pressão positiva contínua nas vias aéreas (CPAP) nasal na sala de parto: manejo e desfechos clínicos em uma maternidade referência

Abstract

Introduction: Nasal Continuous Positive Airway Pressure (CPAP) is a method of non-invasive ventilation that has been increasingly utilized as the primary choice in the treatment of respiratory disorders affecting newborns (NBs) immediately after birth, contributing to improved outcomes. Objectives: To understand the aspects related to the use and clinical outcomes of nasal CPAP in the Delivery Room at a reference maternity hospital, as well as to identify the clinical profile of the studied population and any complications. Materials and Methods: A cross-sectional, retrospective descriptive study involving data from NBs admitted to the Assis Chateaubriand School Maternity (MEAC) from August 2022 to August 2023. The study included forms of NBs subjected to nasal CPAP after birth, regardless of gestational age and birth weight. Data from NBs for whom nasal CPAP was contraindicated were excluded. Results: A total of 161 forms from NBs were analyzed, revealing a predominance of premature infants with low birth weight affected by Neonatal Respiratory Distress Syndrome. Antenatal steroids were used by 79% of pregnant women, and surfactant was administered to 20% of NBs. Invasive mechanical ventilation (IMV) was observed in 18% of cases. The most common complications were pneumothorax (1.9%), pulmonary hemorrhage, and acquired pneumonia (1.2%). Outcomes indicated that 52% were transferred, 48% were discharged, and there was one recorded death. Conclusion: The results suggest a reduction in surfactant and IMV usage, with a low incidence of respiratory complications in NBs subjected to nasal CPAP in the Delivery Room, indicating that MEAC is aligning with good neonatal practices.