Respiratory

Specific Diagnosis ◽

Monitoring Tools ◽

Common Sign ◽

Scoring Tool ◽

Respiratory Conditions ◽

Adequate Oxygenation

Respiratory is the first system-based chapter because adequate oxygenation and ventilation support are critical for stabilizing unwell or at-risk newborns. Respiratory distress is an early, common sign that stabilization is needed. Stabilization includes identifying infants who require intervention; applying the Respiratory Sequence; using a scoring tool to differentiate mild, moderate, or severe respiratory distress and organizing care accordingly; initiating stabilization measures; and monitoring. Related procedures (e.g., intubation), supportive technologies (e.g., continuous positive airway pressure and mechanical ventilation), and monitoring tools (e.g., pulse oximetry) are described. Respiratory conditions include transient tachypnea of the newborn, respiratory distress syndrome, aspiration syndromes, pneumonia, persistent pulmonary hypertension of the newborn, pneumothorax, and pulmonary hypoplasia. Specific diagnosis and management for each condition round out the chapter, with blood gas and chest radiograph interpretations as needed. Two case scenarios show different care pathways for mild, moderate, and severe respiratory distress.

High-Flow Nasal Prong Oxygen Therapy or Nasopharyngeal Continuous Positive Airway Pressure for Children With Moderate-to-Severe Respiratory Distress?*

Pediatric Critical Care Medicine ◽

10.1097/pcc.0b013e31828a894d ◽

2013 ◽

Vol 14 (7) ◽

pp. e326-e331 ◽

Cited By ~ 35

Author(s):

Fia ten Brink ◽

Trevor Duke ◽

Janine Evans

Keyword(s):

Respiratory Distress ◽

Airway Pressure ◽

Oxygen Therapy ◽

High Flow ◽

Nasal Prong ◽

Severe Respiratory Distress

Assessment of the Addition of Prehospital Continuous Positive Airway Pressure (CPAP) to an Urban Emergency Medical Services (EMS) System in Persons with Severe Respiratory Distress

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2013.01.044 ◽

2013 ◽

Vol 45 (2) ◽

pp. 210-219 ◽

Cited By ~ 16

Author(s):

Steve A. Aguilar ◽

Jonathon Lee ◽

Edward Castillo ◽

Bryan Lam ◽

Jennifer Choy ◽

...

Keyword(s):

Respiratory Distress ◽

Emergency Medical Services ◽

Airway Pressure ◽

Medical Services ◽

Emergency Medical

Continuous positive airway pressure (CPAP) to treat respiratory distress in newborns in low- and middle-income countries

Tropical Doctor ◽

10.1177/0049475516630210 ◽

2016 ◽

Vol 47 (1) ◽

pp. 19-22 ◽

Cited By ~ 11

Author(s):

Juan Emmanuel Dewez ◽

Nynke van den Broek

Keyword(s):

Respiratory Distress ◽

Airway Pressure ◽

Large Scale ◽

Middle Income ◽

Mortality And Morbidity ◽

Middle Income Countries ◽

Low And Middle Income

Severe respiratory distress is a serious complication common to the three major causes of neonatal mortality and morbidity (prematurity, intra-partum-related hypoxia and infections). In low- and middle-income countries (LMICs), 20% of babies presenting with severe respiratory distress die. Continuous positive airway pressure (CPAP), is an effective intervention for respiratory distress in newborns and widely used in high-income countries. Following the development of simple, safe and relatively inexpensive CPAP devices, there is potential for large-scale implementation in the developing world. In this article, we describe existing CPAP systems and present a review of the current literature examining the effectiveness of CPAP compared to standard care (oxygen) in newborns with respiratory distress. We also discuss the evidence gap which needs to be addressed prior to its integration into health systems in LMICs.

Bubble continuous positive airway pressure therapy for neonatal respiratory distress at birth in level III newborn unit in Chengalpattu Medical College Hospital: a prospective observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20191992 ◽

2019 ◽

Vol 6 (3) ◽

pp. 906

Author(s):

Diana Grace R. ◽

Suresh Kumar S. ◽

Sathya .

Keyword(s):

Observational Study ◽

Respiratory Distress ◽

Airway Pressure ◽

Tamil Nadu ◽

Prospective Observational Study ◽

College Hospital ◽

Medical College ◽

Respiratory Conditions

Background: Bubble continuous positive airway pressure (bCPAP), a non-invasive respiratory device provides continuous pressure that helps recruitment of more alveoli, increases the lungs, functional residual capacity and decreases the work of breathing in newborns admitted with respiratory distress. Bubble continuous positive airway pressure (bCPAP) is the most important respiratory support in different types of respiratory conditions in level III. In this observational study, author reported this research using bCPAP therapy as the primary respiratory support in level III unit in tertiary care centre in Chengalpattu, Tamil Nadu, India. Despite reporting their indications, duration of use and adverse effects we tried to search for further improvement in other areas of CPAP therapy in level III newborn unit.Methods: This prospective observational study included 250 babies delivered in obstetric unit and admitted with respiratory distress within 6 hours of birth at level III care. They were treated according to level III newborn unit protocol. Those data were collected and entered in the proforma. Newborns were followed up till discharge.Results: A total of 250 babies satisfying the inclusion criteria delivered in Chengalpattu Medical College Hospital, Tamil Nadu, India (mean gestational age 36±2 weeks, mean birth weight 2.5±1.2 kg were included. All newborns were given bCPAP as the primary support. The most common underlying cause of respiratory distress was transient tachypnea of newborn (44%), followed by respiratory distress syndrome (24%) and prolonged respiratory transition (18%). The therapy success rate was 86%. Only 35 newborns failed to respond to CPAP. The most common adverse effect was eye puffiness (19%).Conclusions: Bubble continuous positive airway pressure (b CPAP) therapy use is being well established in level III unit for various respiratory conditions with minimal failure and adverse effects. Its use in extreme preterms and initiation after 6 hours is controversial.

Association of severe respiratory distress syndrome and thyroid agenesis in a term neonate

Zeitschrift für Geburtshilfe und Neonatologie ◽

10.1055/s-2006-943309 ◽

2006 ◽

Vol 210 (S 5) ◽

Author(s):

S Vanhaesebrouck ◽

K Allegaert ◽

F de Zegher ◽

C Vanhole

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Term Neonate ◽

Severe Respiratory Distress Syndrome

Non-invasive duo positive airway pressure ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: a randomized controlled trial

BMC Pediatrics ◽

10.1186/s12887-021-02741-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Arash Malakian ◽

Mohammad Reza Aramesh ◽

Mina Agahin ◽

Masoud Dehdashtian

Keyword(s):

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Airway Pressure ◽

Distress Syndrome ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation

Abstract Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002). Conclusions In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group. Trial registration IRCT20180821040847N1, Approved on 2018-09-10.