ABSTRACT: Objectives: To evaluate the clinical course in preterm neonates with Respiratory Distress Syndrome on bubble Continuous Positive Airway Pressure along with their outcome during stay in hospital. Study Design and Setting: A descriptive case study at the NICU was carried out at Bacha-Khan Medical Complex Swabi from December 2020 to December 2021. Methodology: Respiratory Distress Syndrome was diagnosed by following the criteria: tachypnea (> 60 breaths/min), subcostal retraction and saturation <92%. Clinical course was assessed by mean length of hospital stay from the day of admission to the day of discharge. Outcome was assessed by means of switching the baby to mechanical ventilation by failing CPAP therapy by not maintaining O2 saturation > 92% and tachypnea > 60 breaths/min on 10cm maximum pressure of H2O. CPAP response were noted. Results: Total of 100 patients enrolled in our study, 56 patients were male and 44 patients were female. Mean age was 1.24+0.04days. Mean gestational age of babies was 31.18+0.170weeks. Mean weight of babies was 2.035+0.023kg. Mean hospital stay was 15.05+0.237days. Out of 100 patients included in study 76% babies needed ventilatory support during hospital stay and 24% babies recovered from respiratory distress syndrome without need of ventilator support. Conclusion: Respiratory Distress Syndrome is a fatal complication in Preterm neonates in Neonatal Intensive Care Unit. Respiratory assistance done through continuous positive airway pressure has shown encouraging results in management by preventing complications, mechanical ventilation need, less hospital stay and preventing mortality. Key Words: Respiratory Distress Syndrome, Continuous Positive Airway Pressure, Mechanical Ventilation. Clinical Outcome of Preterm Neonates with Respiratory Distress Syndorme on Continuous Positive Airway Pressure How to cite this Article: Rehman S, Ain Q, Ali W, Bibi R, Ashraf S, Iqbal K. Clinical Outcome of Preterm Neonates with Respiratory Distress Syndorme on Continuous Positive Airway Pressure J Bahria Uni Med Dental Coll. 2022; 12(4):186-90. DOI: https://doi.org/10.51985/JBUMDC202228 Original Article Open Access Sijad-Ur-Rehman, Quratulain, Wahid Ali, Romana Bibi, Sohail Ashraf, Kulsoom Iqbal This is an Open Access article distributed under the terms of the Creative Commons Attribution Non Commercial License (http:// creativecommons/org/licences/by-nc/4.0) which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. INTRODUCTON: Leading causes of infant death and morbidity is respiratory distress syndrome. The illness known as RDS (respiratory distress syndrome in newborns) affects infants whose lungs have not yet reached their fully developed. It could also be attributed to hereditary difficulties with lung development. RDS is most common in babies born before the ages of 34 weeks. 1 At least two of the following clinical signs are required to diagnosis respiratory distress syndrome (RDS): tachypnea (>60/min), dyspnea with dyspnea, and dyspnea with Nasal retractions, subcostal or intercostal retractions, and inspiratory subcostal or intercostal retractions In room air, there is flaring, expiratory grunting, and cyanosis. 2 Severe respiratory distress syndrome (RDS), which is more common in preterm babies of less than 34 weeks, is one of the most common causes of this respiratory failure. It is usually caused by meconium aspiration syndrome in term infants and surfactant deficiency in premature babies. 3 In Malawi, using the bCPAP to support newborns' ventilation is a very cost-effective method, 4 treatment of infant respiratory distress with a low-cost B-CPAP system has been shown to improve overall survival. The benefits were higher for infants with a low birth weight and RDS. 4,5 Bubble CPAP is a Page-186 JBUMDC 2022;12(4):186-190 Sijad-Ur-Rehman Associate Professor, Department of Pediatrics Gujju Khan Medical College / Bacha Khan Medical Complex Sawabi Quratulain Senior Registrar, Department of Pediatrics HITEC Institute of Medical Sciences Taxila Cantt. Wahid Ali Assistant Professor, Department of Pediatrics HBS Medical and Dental College / HBS General Hospital Islamabad Romana Bibi (Corresponding Author) Resident, Department of Gynaecolog/Obstetrics Gynae A Unit, Khyber Teaching Hospital Peshawar Email: romanawazir14@gmail.com Sohail Ashraf Associate Professor, Department of Pediatrics Wah Medical College / National University of Medical Sciecnes Kulsoom Iqbal Assistant Professor, Department of Radiology HITEC Institute of Medical Sciences Taxila Cantt. Received: 24-Feb-2022 Accepted: 16-Sep-2022