Neonatal CPAP guideline
Continuous positive airway pressure (CPAP) is used to hold the airway and
alveoli open during expiration which prevents them from collapsing, therefore
reduces the work of breathing. It provides continuous airflow creating
pressure.
When to use CPAP
 Respiratory distress in a premature neonate
 Meconium aspiration
 Respiratory distress syndrome
 Apnoeas/hypoventilation
Starting CPAP
Every neonate must have a CXR soon after starting CPAP to look for a
pneumothorax. Stop CPAP if pneumothorax present.
Commence CPAP documentation sheet
Start flow at 5Lpm, can increase up to 7Lpm
Care during CPAP
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CPAP chart-Observations, saturations, flow, oxygen
Do not feed, IV fluids
regular oral mouthcare
Oral-gastric tube
Complications
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Pneumothorax
Abdominal distension
Nasal trauma/Nasal septal breakdown
Failure to achieve CPAP pressures
Obstruction of equipment
Agitation of neonate
When to stop CPAP
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Pneumothorax on CXR
Signs of respiratory distress resolved
Respiratory rate under 70
Oxygen under 30%, saturations >95%
Flow 5Lpm or below (flow can be weaned below 5 in premature babies)
Author: Jessica Slater and Anne Bean