scholarly journals Evaluation of the Efficacy of Budesonide Combined with Pulmonary Surfactants on the Neonatal Respiratory Distress Syndrome by Pulmonary Ultrasonography

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Chuanlong Zhang
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Control Group ◽  
Ultrasound Images ◽  
Neonatal Respiratory Distress ◽  
Experimental Group ◽  
Paco2 Level

Objective. This study aimed to investigate the value of lung ultrasound images in evaluating the efficacy of budesonide combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS) in premature infants. Methods. 76 NRDS premature infants admitted to the hospital were randomly divided into experimental group and control group, with 38 children in each group. The premature infants in control group underwent PS, and those in experimental group underwent budesonide combined with PS. After treatment, lung ultrasound imaging was used to evaluate the curative effect, and X-ray results were used as a reference. The changes in clinical signs of two groups were detected, and the pulmonary ultrasound was used to evaluate the clinical efficacy of two groups. The changes in the lung ultrasound score (LUS) and arterial blood gas (ABG) indexes of two groups were compared before and after treatment. Results. LUS and improvement of patients of experimental group were obviously higher than those of the control group after treatment. LUS of experimental group was 12.1 ± 3.7, and that of control group was 18.2 ± 2.3, respectively. The differences were statistically significant ( P  < 0.05). The arterial partial oxygen pressure (PaO2) and oxygenation index (PaO2/FiO2) levels of two groups of patients increased dramatically after treatment. PaO2 and PaO2/FiO2 levels of experimental group were 65.59 ± 12.46 mmHg and 112.57 ± 19.3 mmHg, and those of control group were 45.12 ± 11.21 mmHg and 101.28 ± 21.36 mmHg, respectively. However, arterial partial pressure of carbon dioxide (PaCO2) level was significantly decreased in two groups after treatment. PaCO2 level of experimental group was 40.24 ± 8.92 mmHg, and that of control group was 41.22 ± 9.24 mmHg, respectively ( P  < 0.05). The diagnostic accuracy of lung ultrasound images in two groups was 95.3% and 96.2%, respectively. Conclusion. Pulmonary ultrasonography showed a high diagnostic accuracy in evaluating the efficacy of budesonide combined with PS in the treatment of NRDS in premature infants. It can evaluate the cardiopulmonary function of premature infants with NRDS and effectively improve the respiratory status of premature infants. In conclusion, this study provided some reference value for upgrading the clinical treatment of NRDS in premature infants.

Double-Blind, Randomized Trial of a Calf Lung Surfactant Extract Administered at Birth to Very Premature Infants for Prevention of Respiratory Distress Syndrome

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 593-599 ◽  
Author(s):  
Donald L. Shapiro ◽  
Robert H. Notter ◽  
Frederick C. Morin ◽  
Karl S. Deluga ◽  
Leonard M. Golub ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Lung Surfactant ◽  
Treated Group ◽  
Control Group ◽  
Double Blind ◽  
Severe Respiratory Distress

Organic solvent extraction of surfactant obtained by lavage of calf lungs yields a highly surfaceactive material. A double blind, randomized clinical trial to determine the effect of this material on respiratory distress syndrome in premature infants was initiated in the Neonatal Intensive Care Unit at the University of Rochester in December 1983. Infants 25 to 29 weeks gestational age were eligible for entry into the trial. At the time of this interim analysis 32 patients had been randomly selected and entered into the trial, 16 surfactant-treated patients and 16 in a control group who received only saline. At birth, intrapulmonary instillation of the calf lung surfactant extract dispersed in saline or saline alone occurred in the delivery room immediately after intubation and prior to ventilation; infants were then ventilated and treated as usual. At 6, 12, 24, 48, and 72 hours after birth, the severity of respiratory distress was categorized as either minimal, intermediate, or severe based on oxygen and mean airway pressure requirements. Differences observed at six hours after birth were of marginal significance, but at 12 and 24 hours the surfactant-treated group had significantly (P &lt; .01) less severe respiratory distress compared with the control group. Differences between treated and control infants were not statistically significant at 48 and 72 hours after birth. In four surfactant-treated infants the severity of respiratory distress worsened between 24 and 48 hours after birth, suggesting that one dose of surfactant at birth may not be sufficient for some infants.

scholarly journals Lung ultrasound in diagnosing neonatal respiratory distress syndrome: a meta-analysis

2019 ◽  
Vol 59 (6) ◽  
pp. 340-8
Author(s):  
Hanum Ferdian ◽  
Dian Ibnu Wahid ◽  
Samad Samad ◽  
Anggun Esti Wardani ◽  
Guntur Surya Alam ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Sensitivity And Specificity ◽  
Diagnostic Tool ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Neonatal Respiratory Distress Syndrome ◽  
Inclusion Criteria ◽  
Neonatal Respiratory Distress

Background Neonatal respiratory distress syndrome (NRDS) is commonly diagnosed by clinical sign and symptoms, blood gas analysis, and chest x-ray. In the past, lung ultrasound (LUS) was not standard for NRDS examination. Many studies show that ultrasound diagnostic tool for NRDS is accurate, reliable, low cost, easy to use, and safe because due to no ionizing radiation. Objective To determine the sensitivity and specificity of LUS in diagnosing NRDS. Methods This meta-analysis study was conducted LUS as a diagnostic tool for NRDS. Inclusion criteria were all studies from PubMed, Embase, and The Cochrane Library, without any limitation on published journals, as well as using keywords or search terms of ultrasound, neonatal, and respiratory distress syndrome. Statistical analysis was undertaken using MedCalc® version 18.2 software. Results Seven studies with a total of 580 patients met the inclusion criteria. Proportional meta-analysis obtained random effects models, with total sensitivity of LUS was 97.2% (95% CI for I2 74.24 to 92.88; P<0.0001) and specificity of LUS was 94.8% (95% CI for I2 88.60 to 98.03; P<0.00001). Conclusion Lung ultrasound should be considered as a diagnostic tool for NRDS because it is high in sensitivity and specificity, inexpensive, safe, as well as limited radiation exposure.

scholarly journals Expression of Pulmonary Surfactant-Associated Protein B in Neonatal Respiratory Distress Syndrome

2013 ◽  
Vol 32 (2) ◽  
pp. 146-151
Author(s):  
Xiaojuan Yin ◽  
Yan Wang ◽  
Lu Xie ◽  
Xiangyong Kong ◽  
Chunzhi Wang ◽  
...  
Keyword(s):  
Protein Expression ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Mrna Expression ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Neonatal Respiratory Distress Syndrome ◽  
Control Group ◽  
Neonatal Respiratory Distress ◽  
Protein B

Summary Background: The aim of this study was to investigate the role of pulmonary surfactant-associated protein B (SP-B) expression in the pathogenesis of neonatal respiratory distress syndrome (RDS) via detecting the protein and mRNA expression of SP-B. Methods: A total of 60 unrelated neonates who died of RDS were chosen as the RDS group and then subgrouped into ≤32 weeks group, 32∼37 weeks group and ≥37 weeks group (n=20). Sixty neonates who died of other diseases were enrolled as controls and subdivided into 3 matched groups based on the gestational age. Western blot assay and RT-PCR were employed. Results: In the RDS group, SP-B protein expression was reduced or deficient in 8 neonates of which 6 had no SP-B protein expression. In the control group, only 1 had reduced SP-B protein expression. The reduced or deficient SP-B protein expression in 9 neonates of both groups was noted in the ≥37 weeks group. In the RDS group, the SP-B mRNA expression was significantly lower than that in the control group. In the ≤37 weeks group, SP-B mRNA expression was comparable between the RDS group and control group. In the 32∼37 weeks group, the SP-B mRNA expression in the RDS group was significantly reduced when compared with the control group. In the ≥37 weeks group, the SP-B mRNA expression in the RDS group was dramatically lower than that in the control group. Conclusions: Alteration of SP-B expression is present at transcriptional and translational levels. Reduction of SP-B mRNA and protein expression is involved in the pathogenesis of RDS.

scholarly journals Application Value of a New Lung Ultrasound Scoring Method in Neonatal Respiratory Distress Syndrome Treatment 

2020 ◽  
Author(s):  
Qiu-xia Jiang ◽  
Li-jing Shi ◽  
Long-yuan Shen ◽  
Xiao-qing Li ◽  
Rong-sen Hung ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Neonatal Respiratory Distress Syndrome ◽  
Scoring Method ◽  
Neonatal Respiratory Distress ◽  
Pre Treatment

Abstract We studied a 14-zone lung ultrasound scoring method to quantify the efficiency of pulmonary surfactant treatment and to determine the timing of mechanical ventilation in neonates with neonatal respiratory distress syndrome. In this prospective study, we identified 88 neonates who received pulmonary surfactant replacement therapy. We measured surfactant efficiency using the 14-zone scoring method pre-treatment and at 12 h, 24 h, 48 h, and 72 h post-treatment. The ultrasound score was inversely associated with pulmonary surfactant treatment. We also identified 67 neonates on mechanical ventilation. We applied the scoring method when the infants met criteria for ventilator withdrawal. A comparison of pre-treatment to 12 h post-treatment showed that scoring method was significantly different (t = 4.08, P < 0.05); other scoring methods did not differ (P > 0.05). Thus, the scoring method performed better on withdrawal time. A score of 41.0 was defined as the threshold for risk of withdrawal failure with 92.36% sensitivity and 93.80% specificity, with an area under the curve of 0.955. Conclusion: The new 14-zone lung ultrasound scoring method improved scoring on the efficacy of pulmonary surfactant and had good diagnostic efficiency for timing the removal of mechanical ventilation in neonatal respiratory distress syndrome.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 45 (2) ◽  
pp. 338-338
Author(s):  
Frank Giunta
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Nursing Care ◽  
Distress Syndrome ◽  
Control Group ◽  
Blood Gas ◽  
Blood Samples ◽  
The Past ◽  
Frequent Monitoring

Dr. Giunta commented as follows: The doctor is perfectly correct in questioning whether there was a reason for doing the study as we did. From the start, it was apparent that the study would include very sick premature infants such as those with respiratory distress syndrome who would require intensive nursing care, frequent monitoring of equipment, as well as blood gas determinations and chemistries. Since supplemental lighting such as with gooseneck lamps had been used in the past during feeding, monitoring, and drawing blood samples, it was felt that clothing the control group would expose them to a minimum of additional light.

scholarly journals Neonatal respiratory distress syndrome: Chest X-ray or lung ultrasound? A systematic review

Ultrasound ◽  
2017 ◽  
Vol 25 (2) ◽  
pp. 80-91 ◽  
Author(s):  
Matthew Hiles ◽  
Anne-Marie Culpan ◽  
Catriona Watts ◽  
Theresa Munyombwe ◽  
Stephen Wolstenhulme
Keyword(s):  
Respiratory Distress Syndrome ◽  
Diagnostic Accuracy ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Neonatal Respiratory Distress Syndrome ◽  
Reference Standard ◽  
Air Leak ◽  
Gestation Age ◽  
Neonatal Respiratory Distress

Background and aim Neonatal respiratory distress syndrome is a leading cause of morbidity in preterm new-born babies (<37 weeks gestation age). The current diagnostic reference standard includes clinical testing and chest radiography with associated exposure to ionising radiation. The aim of this review was to compare the diagnostic accuracy of lung ultrasound against the reference standard in symptomatic neonates of ≤42 weeks gestation age. Methods A systematic search of literature published between 1990 and 2016 identified 803 potentially relevant studies. Six studies met the review inclusion criteria and were retrieved for analysis. Quality assessment was performed before data extraction and meta-analysis. Results Four prospective cohort studies and two case control studies included 480 neonates. All studies were of moderate methodological quality although heterogeneity was evident across the studies. The pooled sensitivity and specificity of lung ultrasound were 97% (95% confidence interval [CI] 94–99%) and 91% (CI: 86–95%) respectively. False positive diagnoses were made in 16 cases due to pneumonia (n = 8), transient tachypnoea (n = 3), pneumothorax (n = 1) and meconium aspiration syndrome (n = 1); the diagnoses of the remaining three false positive results were not specified. False negatives diagnoses occurred in nine cases, only two were specified as air-leak syndromes. Conclusions Lung ultrasound was highly sensitive for the detection of neonatal respiratory distress syndrome although there is potential to miss co-morbid air-leak syndromes. Further research into lung ultrasound diagnostic accuracy for neonatal air-leak syndrome and economic modelling for service integration is required before lung ultrasound can replace chest radiography as the imaging component of the reference standard.

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