scholarly journals Lung recruitment improves the efficacy of intubation-surfactant-extubation treatment for respiratory distress syndrome in preterm neonates, a randomized controlled trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong Yang ◽  
Wenkang Yan ◽  
Minyi Ruan ◽  
Lan Zhang ◽  
Jinzhen Su ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Multivariate Logistic Regression Analysis ◽  
Lung Recruitment ◽  
Preterm Neonates ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Significant Difference

Abstract Background Lung recruitment is a maneuver used to decrease the length of intubation in preterm neonates. This study aimed to compare the therapeutic efficacy of lung recruitment plus intubation-surfactant-extubation (INSURE) procedure and INSURE alone for the preterm neonates with respiratory distress syndrome. Methods From 2017 to 2019, 184 preterm neonates (gestational age 24–32 weeks) with respiratory distress syndrome were enrolled and randomized into the lung recruitment group receiving lung recruitment (25 cm H2O, 15 s) plus INSURE and the control group receiving INSURE only. The primary outcome was the need for mechanical ventilation (MV) within 72 h after extubation. The secondary outcomes included duration of MV, noninvasive ventilation, total oxygen therapy, hospitalization time, and complications. Results Compared to the control group, the lung recruitment group had a significantly lower proportion of preterm neonates requiring MV within 72 h after extubation (23% vs. 38%, P = 0.025) and pulmonary surfactant administration, as well as a shorter MV duration. There was no significant difference in the incidences of complications (all P > 0.05) and in-hospital mortality (2% vs. 4%, P = 0.4) between the lung recruitment group and control group. Multivariate logistic regression analysis demonstrated that the control group had a 2.17-time higher risk of requiring MV than the lung recruitment group (AOR: 2.17, 95% CI: 1.13–4.18; P = 0.021). Compared with infants with a normotensive mother, infants with a hypertensive mother have a 2.41-time higher risk of requiring MV (AOR: 2.41, 95% CI: 1.15–5.05; P = 0.020). Conclusion Lung recruitment plus INSURE can reduce the need for MV within 72 h after extubation and did not increase the incidence of complications and mortality. Trial registration Chinese Clinical Trial Registry ChiCTR1800020125, retrospectively registered on December 15, 2018.

Lung Recruitment Improves the Efficacy of Intubation-Surfactant-Extubation Treatment for Respiratory Distress Syndrome in Preterm Neonates, A Randomized Controlled Trial

2021 ◽  
Author(s):  
Yong Yang ◽  
Wenkang Yan ◽  
MinYi Ruan ◽  
Lan Zhang ◽  
Jinzhen Su ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Primary Outcome ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Multivariate Logistic Regression Analysis ◽  
Lung Recruitment ◽  
Preterm Neonates ◽  
Control Group ◽  
Complications And Mortality

Abstract Background: Lung recruitment is a maneuver in preterm neonates at birth, which may decrease the length of intubation. This study aimed to compare the therapeutic efficacy of lung recruitment plus intubation-surfactant-extubation (INSURE) procedure and INSURE alone for the preterm neonates with respiratory distress syndrome.Methods: A total of 184 preterm neonates with respiratory distress syndrome from 2017 to 2019 were enrolled and randomized into the lung recruitment group receiving lung recruitment (25 cm H2O for 15 seconds) plus INSURE and the control group receiving INSURE only. The primary outcome was the need for mechanical ventilation (MV) within 72 h after extubation. The secondary outcomes include the duration of intubation, noninvasive ventilation, total oxygen therapy, hospitalization, and other complications.Results: Compared to the control group, the lung recruitment group had a significantly lower proportion of preterm neonates need for MV within 72 h after extubation (23% vs. 38%, P=0.025) and pulmonary surfactant administration, as well as shorter the MV duration. Multivariate logistic regression analysis demonstrated that the control group had a 2.17-time higher risk for need for MV than the lung recruitment group (OR: 2.17, 95% CI: 1.13-4.18; P=0.021). In the mothers with hypertension, the infants presented a 2.41-time higher risk for requiring MV as compared with those of mothers with normotension (OR: 2.41, 95% CI: 1.15-5.05; P=0.020). Conclusion: These data suggested that lung recruitment plus INSURE can reduce the need for MV within 72 hours after extubation without increasing the incidence of complications and mortality.

BODY WATER COMPARTMENTS IN THE PREMATURE INFANT, WITH SPECIAL REFERENCE TO THE EFFECTS OF THE RESPIRATORY DISTRESS SYNDROME AND OF MATERNAL DIABETES AND TOXEMIA

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 883-889
Author(s):  
Wesley M. Clapp ◽  
L. Joseph Butterfield ◽  
Donough O'Brien
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Total Body Water ◽  
Distress Syndrome ◽  
Body Water ◽  
Control Group ◽  
Extracellular Water ◽  
Water Compartments ◽  
Significant Difference ◽  
Total Body

Normal values for both total body water and extracellular water have been determined in 86 premature infants aged 1 to 90 days and weighing 940 to 2,435 gm, with use of the techniques of deuterium oxide and bromide dilution. Nine full-term infants aged 1 to 6 days and weighing 2,590 to 4,985 gm were similarly studied. Nine infants with the respiratory distress syndrome and eight infants of toxemic mothers studied in the first 24 hours of life showed no significant difference in their body water compartments in comparison to a control group of normal infants matched for age and weight. Seven infants of diabetic mothers studied in the first 24 hours of life showed a significant decrease in total body water, expressed as percentage of body weight, with a normal intracellular to extracellular water ratio. These data indirectly support other evidence that there is an increase in body fat in these infants at birth. See Table in the PDF file

scholarly journals Association between Thyroid Stimulating Hormone and Respiratory Distress Syndrome of Newborn in the Preterm Infants

2020 ◽  
Author(s):  
Young Jin Kim ◽  
Byoung Kook Kim ◽  
Yong Hyuk Kim
Keyword(s):  
Thyroid Hormone ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Control Group ◽  
Lower Serum ◽  
Significant Difference ◽  
Serum Tsh ◽  
Tsh Levels

Abstract Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T3 and fT4 level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T3 and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT4) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.

Phototherapy Effect on the Incidence of Patent Ductus Arteriosus in Premature Infants: Prevention With Chest Shielding

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Warren Rosenfeld ◽  
Shashi Sadhev ◽  
Verlaine Brunot ◽  
Ramesh Jhaveri ◽  
Ignacio Zabaleta ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Control Group ◽  
Patent Ductus

Patent ductus arteriosus is common among premature neonates, especially those with birth weights less than 1,500 g. In vitro, room light inhibits the contraction of immature piglet's ductal rings. Because phototherapy is used frequently from the first days of life to treat jaundice in preterm neonates, we compared the occurrence of patent ductus arteriosus among premature infants exposed to this intense light source with those whose chests were shielded. Seventy-four babies with respiratory distress syndrome were randomly assigned to either a treatment group (chest shielded with aluminum foil while on phototherapy, 36 babies) or control group (no shield, 38 babies). All were on radiant warmers, received mechanical ventilation for respiratory distress syndrome, and phototherapy (Air Shields model PTU 78-1) from day 1 of life. Irradiance was maintained at &gt;4.0 µW/cm2/nm in all cases. Although both groups had similar birth weights, gestational ages, severity of respiratory distress syndrome, intravenous fluid intake, and duration of phototherapy, the incidence of patent ductus arteriosus was significantly less in the shield group (shield 11/36 v No shield 23/38; P = .009). Patent ductus arteriosus murmurs developed in shielded patients at a later date, they required less vigorous treatment (ie, indomethacin), and they had shorter hospitalizations (74 v 85 days; P &lt; .05). The significant reduction of patent ductus arteriosus with shielding suggests that phototherapy may play a role in the occurrence of patent ductus arteriosus in premature infants. Shielding may be a practical method to decrease this common complication should this initial observation be confirmed.

Role of lung ultrasound in the assessment of recruitment maneuvers in ventilated preterm neonates with respiratory distress syndrome and its correlation with tracheal IL-6 levels: A randomized controlled trial

2020 ◽  
pp. 1-6
Author(s):  
N.M.A. Shady ◽  
H.A.S. Awad ◽  
D.R. Kamel ◽  
E.M. Fouda ◽  
N.T. Ahmed ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Controlled Trial ◽  
Controlled Study ◽  
Preterm Neonates ◽  
Invasive Ventilation ◽  
Randomized Controlled ◽  
Group I

BACKGROUND: This study’s aim is to evaluate lung ultrasound (LUS) efficacy in detecting opening and closing lung pressures and its correlation with the tracheal interleukin 6 (IL-6) level. METHOD: This single-blinded randomized controlled study was done at Ain Shams University Children’s Hospital neonatal intensive care units, Egypt. It consists of 44 mechanically ventilated preterm neonates with Respiratory Distress Syndrome (RDS). Initial LUS assessment was done followed by randomization to one of 2 groups; group I: 22 patients underwent LUS guided RM and group II: 22 patients underwent non-ultrasound guided RM. Tracheal IL-6 level was measured before and after RM in both groups. RESULTS: The LUS scores showed a sensitivity of 86.7% , specificity of 62.10% and accuracy of 70.45% at the cut-off point >B1 grade. After RM, there was a higher percentage of changes in mean airway pressure (p = 0.03), FiO2 (p = 0.01), PaO2/FiO2 ratio (p = 0.01), and IL-6 (p <  0.01) in group I. The duration of oxygen requirement (6 vs.13.5 days, p = 0.01), invasive ventilation (3 vs.5.5 days, p = 0.03), non-invasive ventilation (2.5 vs. 5 days, p = 0.02) and NICU stay (21.5 vs. 42.5 days, p = 0.03) was less in group I. A positive correlation between reaeration score and the duration of O2 requirement (p = 0.002), duration of invasive ventilation (p = 0.001), NICU length of stay (p = 0.002) and negative correlation with PaO2/FiO2 ratio before RM (p = 0.012). The best cut-off point for the reaeration score is >21 with a sensitivity of 75% , specificity of 71.43% and area under the curve of 78.1% . CONCLUSION: LUS-guided RM achieved earlier lowest FiO2, shorter O2 dependency, lesser NICU stay and marked decrease in lung inflammation by decreasing atelectotrauma and shortening the duration of invasive ventilation.

scholarly journals Novel predictor markers for early differentiation between transient tachypnea of newborn and respiratory distress syndrome in neonates

2021 ◽  
Vol 35 ◽  
pp. 205873842110005
Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada M Al-Ashmawy ◽  
Sally Abu-Risha ◽  
Haidy Khattab
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Sensitivity And Specificity ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
University Hospital ◽  
Control Group ◽  
Blood Ph ◽  
Early Predictors ◽  
Significant Difference

Neonatal Respiratory Distress Syndrome (RDS) and Transient Tachypnea of newborn (TTN) are common similar neonatal respiratory diseases. Study the early predictor markers in differentiation between TTN and RDS in neonates. A prospective case control study which was done in Neonatal Intensive Care Unit (NICU) of Tanta University Hospital (TUH) from September 2016 to March 2018. Three groups of neonates were included in the study: RDS group (45 neonates), TTN group (45 neonates), and control group (45 healthy neonates). There were statistically significant difference (SSD) between our studied three groups as regard serum Malondialdehyde (MDA), Superoxide dismutase SOD, Lactate dehydrogenase (LDH), and blood PH and P-values were 0.001* for these comparative parameters. The ROC curve of RDS cases revealed that the serum MDA Cut off, sensitivity and specificity were 1.87 mmol/L, 98%, 96%, respectively which had the highest sensitivity and specificity followed by the serum SOD then the serum LDH and lastly the blood PH while in TTN cases, the serum MDA Cut off, sensitivity and specificity were 0.74 mmol/L, 96%, 93%, respectively then the serum SOD then the serum LDH and lastly the blood PH. Serum MDA, SOD, LDH, and PH had a beneficial role as early predictors in differentiation between TTN and RDS in neonates.

scholarly journals Assessment of 5-Year Outcomes of Life Satisfaction in Acute Respiratory Distress Syndrome Survivors After Rehabilitation Programs: A Prospective, Multicenter, Randomized Controlled Trial

2021 ◽  
Author(s):  
Farshid Rahimi-Bashar ◽  
Mahmood Salesi ◽  
Keivan Gohari-Moghadam ◽  
Mohamad Amin Pourhoseingholi ◽  
Amir Vahedian_Azimi
Keyword(s):  
Life Satisfaction ◽  
Acute Respiratory Distress Syndrome ◽  
Pulmonary Function ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Control Group ◽  
Multicenter Randomized Controlled Trial ◽  
Empowerment Model

Abstract The use of rehabilitation program for survivors of Acute Respiratory Distress Syndrome (ARDS) could be one of the important and fundamental steps to improve the pulmonary function and health related quality of life (HRQoL) of patients. This study was carried out to evaluate the effect of two rehabilitation techniques (Family-Based Empowerment Model (FECM)/Continuing Care Model (CCM), or both of them) on pulmonary function and HRQoL in ARDS survivor. From December 2009 to October 2014, ARDS survivors from mixed medical-surgical ICUs at four academic teaching hospitals in Tehran, Iran, randomly assigned to one of three intervention groups (A, B or C) or a control group (D). Pre- and post-interventions, pulmonary functions and HRQoL status of patients in all groups were collected 48 times through clinical measurements and various questionnaires during 5 years of follow-up. Significantly improvement was seen in the intervention groups compared to the control group, and the greatest benefit was observed in patients that received mixed of FCEM and CCM rehabilitation techniques. Co-administration of FCEM and CCM can improve pulmonary function as well as the life satisfaction of ARDS survivors. As a result, the execution of the empowerment model by nurses is recommended for ARDS survivors and the participation of their families at the same time. Trial registration: NCT02787720 (ClinicalTrial.gov, 01/06/2016).

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