1. Bubble CPAP Best way to treat Respiratory Distress in Neonates
Jay Kothadia, MD
Pediatrix Medical Group
Presbyterian Hospital
Charlotte, NC

2. Average Daily Census

3. Monthly Average Daily Census Presbyterian Hemby ICN 2006

4. ICN SURVIVAL 2003-2006 Gestational Age 94.6% Survival N = 1,836

5. 02 Saturation Management April 2005

6. Bubble CPAP April 2006

7. CPAP advantages Stabilizes alveoli, prevents collapse or atelectasis.
Achieves better lung volume
Provides better ventilation/perfusion match
Conserves surfactant
Increases lung compliance

8. CPAP advantages
Decreases need for intubation's, surfactant and mechanical ventilation.
Improved work of breathing.
Lower concentration of FiO2 need.
Decreases days on O2.
Lower risk for BPD.

9. CPAP advantages Decreases Ventilator associated Pneumonias.
Decreases risk for nosocomial sepsis.
Decreases severity of ROP.
Possible better growth.
May decreases length of Hospital stay.

10. Annual Survanta usage

11. Sufactant Expense

12. Average Ventilator days by GA 2004-2006

13. < 30 wks GA babies diagnosed with Hypotension 2004-2006

14. < 30 wks GA babies treated with Dopamine or Dobutamine 2004-2006

15. < 30 wks GA babies treated with Decadron 2004-2006

16. Surgical ROP before and after O2 saturation change (percent)
15 months before and after O2 policy change.

17. < 30 wks GA babies discharged home on Oxygen 2004-2007

18. < 30 wks GA babies: Average length of stay 2004-2007

19. Average Length of Stay (Days) Hemby Intensive Care Nursery 2004-2006

20. ICN SURVIVAL 2004-2007 Gestational Age

21. Starting Bubble CPAP Dedicated team Education Equipment and supply
Criteria to place on CPAP
Monitor placement

22. Bubble CPAP