Continuous positive airway pressure (CPAP) is used to maintain continuous positive pressure during both inspiratory and expiratory phases when the infant is breathing spontaneously.

Its effects include:

• increase in functional residual capacity leading to an increase in PaO₂
• increases pulmonary compliance
• increases spontaneous tidal volume and reduces respiratory effort
• decrease in alveolar-arterial oxygen pressure gradient
• prevents alveolar collapse
• increases airway diameter
• conserves surfactant
• splints the airway
• splints the diaphragm
• reduces mechanical obstruction (eg. meconium)

• The baby may be nursed prone, skin to skin (kangaroo), supine or side lying (that is, there are no limitations to positioning!)
• Orogastric feeds are as ordered / tolerated.  

Indications for CPAP

• Any signs of significant respiratory distress
  • Tachypnoea
  • flaring
  • grunting
  • retractions
  • cyanosis
  • O₂ requirement
• Diseases with low functional residual capacity (FRC)
  • RDS
  • TTN
  • Pulmonary oedema
• Meconium Aspiration Syndrome
• Airway closure disease
  • BPD
  • Bronchiolitis
  • Apnoea and bradycardia of prematurity
• Weaning from mechanical ventilation
• Tracheomalacia
• Diaphragmatic paralysis