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CPAP is an acronym for "continuous positive airway pressure." Neonatal CPAP is medical equipment used to help newborn infants breathe. Infants born before 36 weeks gestation may not have fully developed lungs and may be unable to breathe on their own. In these cases, the infant wears a device that sends a stream of air into the nose and down the trachea. This creates a small amount of positive pressure in the airway, holding it open and allowing the child to breathe.
Infants born before 28 weeks gestation may lack a normal lung lubricant called surfactant. Surfactant allows the lungs to expand and collapse without the tissues sticking to one another. When an infant lacks surfactant, the lungs can collapse, resulting in a breathing problem known as neonatal respiratory distress syndrome. For these children, using a neonatal CPAP is lifesaving. It allows them to breathe and reduces the need for more invasive ventilation machines.
Neonatal CPAP is also referred to as noninvasive ventilation and may prevent the need for ventilators. Ventilators require a breathing tube to be inserted into the child’s throat and down the trachea. The air is delivered at a higher pressure and the breathing tube can introduce bacteria, causing lung infections. The risk of complications from ventilators is higher than for neonatal CPAP.
A child with respiratory distress syndrome may need to be sent home with a nasal neonatal CPAP. A portable machine is kept at the child's bedside, much like an adult sleep apnea machine. A nasal cannula delivers the mildly pressurized oxygen into the child's nose through flexible plastic tubing. The machine does not breathe for the child; the child still breathes on his own. The goal is to wean the child off neonatal CPAP, and a neonatal respiratory team will help the child to achieve that goal.
Neonatal CPAP is lifesaving but not without risks. Excessive oxygen or pressure can cause tears in the lung tissue, leading to a collapsed lung. The high level of oxygen also can damage the retina of the eye, resulting in blindness. Other complications include blood clots or bleeding into the brain, which may result in long-term brain damage. To prevent these complications, the level of oxygen and pressure need to be lowered as soon as possible.
The need for neonatal CPAP can be reduced by preventing early labor. Proper prenatal care for the mother, including regular visits to the doctor and proper nutrition, results in a healthier baby. Preterm labor can sometimes be halted using medication, giving the infant more time to develop in the uterus. For babies with a high risk of being born early, corticosteroid medication given to the mother can induce the infant’s lungs to mature more quickly.