scholarly journals Association of Antenatal Corticosteroid Administration-to-delivery Interval With Neonatal Respiratory Distress Syndrome and Respiratory Support in Preterm Infants

2022 ◽  
Author(s):  
Lixia Li ◽  
Haijing Li ◽  
Yejun Jiang ◽  
Beimeng Yu ◽  
Xiuren Wang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Preterm Infants ◽  
Birth Interval ◽  
Distress Syndrome ◽  
Delivery Room ◽  
Respiratory Support ◽  
Neonatal Respiratory Distress

Abstract Background: Administration of antenatal corticosteroids (ACS) is an effective strategy for the management of preterm infants, which can improve neonatal respiratory distress syndrome (NRDS) and attenuate the risk of neonatal mortality. However, many preterm infants do not expose to a complete course of ACS administration, and the effects of different ACS-to-delivery intervals on NRDS and respiratory support remain unclear.we explore the relationships of ACS administration-to-birth intervals with NRDS and respiratory support in preterm infants in this study.Methods: In this retrospective cohort study, the preterm infants born between 240/7 and 316/7 wk of gestation were recruited from Jan 2015 to Jul 2021. All participants were categorized based on the time interval from the first ACS dose to delivery: <24 h, 1-2 d, 2-7 d, and more >7 d. Multivariable logistic regression analysis was conducted to examine the relationships between ACS-to-birth interval and primary or secondary outcome, while adjusting for potential confounders.Results: Of the 706 eligible neonates, 264, 83, 292 and 67 received ACS-to-delivery intervals of <24 h, 1-2 d, 2-7 d and >7 d, respectively. After adjusting these confounding factors, multivariable logistic analysis showed a significant increased risk of NRDS (aOR: 1.8, 95% CI: 1.2-2.7), neonatal mortality (aOR: 2.8, 95% CI: 1.1-6.8), the need for surfactant use (aOR: 2.7, 95% CI: 1.7-4.4), endotracheal intubation in delivery room (aOR: 1.9, 95% CI: 1.0-3.7), mechanical ventilation (aOR: 1.9, 95% CI: 1.1-3.4) in the ACS-to-delivery interval of <24 h group when compared with the ACS-to-birth interval of 2-7 d group. Similar findings were observed in the subgroup analysis of the ACS interval of <6 h and 6-12 h groups (incidence of death and surfactant use), but no obvious differences were found in the ACS intervals of 12-24 h, 1-2 d and >7 d groups compared with the ACS-to-birth interval of 2-7 d group.Conclusions: Neonatal outcomes such as NRDS, neonatal mortality, the need for surfactant use, intubation in delivery room, mechanical ventilation are at a higher risk when the neonates exposed to ACS interval for less than 12 h before delivery.

scholarly journals Efficacy and safety of minimally invasive surfactant administration in preterm infants with neonatal respiratory distress syndrome: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Xiao Hong Wu ◽  
Zhoushan Feng ◽  
Juan Kong ◽  
Yiyu Lai ◽  
Chunhong Jia ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Minimally Invasive ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Control Group ◽  
Neonatal Respiratory Distress ◽  
Surfactant Administration

Abstract Background: The effects of minimally invasive surfactant administration (MISA) in preterm infants with neonatal respiratory distress syndrome (NRDS) are unclear. Methods: We searched randomized controlled trials (RCTs) and compared MISA techniques with intubation for surfactant delivery in preterm infants with NRDS in PubMed, Embase, Cochrane Library, and Web of Science. Results: Thirteen RCTs (1931 infants) were included in the meta-analysis. The use of MISA techniques decrease the incidence of bronchopulmonary dysplasia (BPD) at 36 weeks, pneumothorax, and hemodynamically significant patent ductus arteriosus (hsPDA) (Risk Ratio(RR) : 0.59, 95% confidence interval (CI) : 0.46 to 0.75, p < .0001; RR : 0.60, 95% CI : 0.39 to 0.93, p= .02 and RR : 0.88, 95% CI : 0.78 to 1.00, p= .04, respectively). In addition, infants in the MISA group required less mechanical ventilation within 72 h of life or during hospitalization (RR : 0.60, 95% CI : 0.48 to 0.75, p< .00001 and RR : 0.64, 95% CI : 0.49 to 0.82, p = .0005, respectively) compared with infants in the control group. However, the rate of surfactant reflux was higher in the MISA group than that in the control group (RR : 2.12, 95% CI : 1.37 to 3.29, p = .0008). There were no significant differences in mortality and other outcomes beteween the MISA group and the control group. Conclusions: The administration of surfactant with MISA techniques could lower the requirement for mechanical ventilation, and decrease the incidence of BPD at 36 weeks, pneumothorax, and hsPDA.

INSURE (INtubate, SURfactant and Extubate) method in preterm infants with respiratory distress syndrome: a retrospective study

2020 ◽  
Author(s):  
Mohamed Mubarak Shaik Kidur Mohideen ◽  
Deepika Wagh ◽  
Sam Athikarisamy
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
P Value ◽  
Severe Respiratory Distress ◽  
Surfactant Administration

Abstract Background: Preterm infants with severe respiratory distress syndrome (RDS) are usually managed with endotracheal intubation and surfactant administration followed by mechanical ventilation however this has immediate and long-term complications. Hence, INSURE (Intubate, surfactant administration and extubate) method combined with continuous positive airway pressure (CPAP) support has been accepted as an alternative method in eligible infants. Aim of this study is to look at our experience of administering INSURE and to look at the factors predisposing to the failure of INSURE. Methods: A retrospective chart review was done of all the babies who were born in a tertiary hospital between 1 st January 2014 to 31 st December 2015 (2 years) and received surfactant through INSURE method. Infants requiring reintubation and mechanical ventilation within 3 days post INSURE are considered as INSURE failure for our study purpose. Results: Eighty-five infants were included in the review with gestational age (GA) ranging from 26 +3 to 35 +5 weeks and birth weight ranging from 680 to 3340 grams. Of these, 22 infants (26%) had INSURE failure. INSURE failure rate was higher in infants born <30 weeks gestation (40%). Higher FiO2 requirement prior to INSURE (mean FIO 2 0.5 vs 0.3, P value <0.001) and preeclampsia in mothers of infants < 30 weeks of GA (P value 0.027) were strongly associated with INSURE failure. No mortality was noted in either group. Conclusion: We found that INSURE method may be useful in preventing the need for mechanical ventilation in late preterm infants with RDS. However, this method may be less successful in preterm infants with lower GA (<30 weeks) and higher FiO2 requirement (≥0.5). More prospective studies are needed to assess the effectiveness of INSURE method.

Competing Risk Analysis of the Health Status of Neonates with Respiratory Distress Syndrome

2020 ◽  
Author(s):  
Zenaw Ayele ◽  
Mekonnen Tadesse ◽  
Zelalem Tazu
Keyword(s):  
Prognostic Factors ◽  
Birth Weight ◽  
Health Status ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Preterm Infants ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Competing Risk

Introduction: Respiratory distress syndrome (RDS) is not only the most common respiratory disorder in premature infants but also the main cause of neonatal mortality. Methods: Competing risk framework was used to examine and identify potential prognostic factors of the health status of preterm infants with respiratory distress syndrome. Preterm infants with RDS admitted to the neonatal intensive care units (NICUs) of selected hospitals in Ethiopia were followed for 28 days and only neonates with complete cases were included in the analysis. The Fine-Gray or sub-distribution hazard model was used to identify significant prognostic factors. Three outcome variables (death due to RDS, death due to other causes and discharged alive) were considered. Results: The Fine-Gray model fit results revealed that anemia, multiple pregnancies, birth-weight and gestational age were the prognostic factors significantly associated with the death of neonates due to Respiratory distress syndrome problem while Pneumonia, meningitis, anemia and gestational age of neonates were the significant prognostic factors for death of neonates due to other causes. Moreover, pneumonia, birth weight and gestational age were identified as the prognostic factors associated with neonates being discharged alive. Conclusion: Offering intensive and adequate treatments for neonates with lowest birth-weights and gestational age may be useful to reduce neonatal mortality and increase the incidence of being discharged alive.

scholarly journals Noninvasive High-Frequency Shock Ventilation Based on Chest X-Ray Reconstruction Algorithm for Neonatal Respiratory Distress Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Xu Sang ◽  
Zhen Zhang ◽  
Yumeng Wu ◽  
Wansheng Peng ◽  
Xin Chen
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
High Frequency ◽  
Distress Syndrome ◽  
Neonatal Respiratory Distress Syndrome ◽  
Respiratory Support ◽  
Ventilation Mode ◽  
Cpap Ventilation ◽  
Neonatal Respiratory Distress ◽  
Hospital Stays

Objective. To explore the use of the noninvasive high-frequency oscillatory ventilation and CPAP ventilation mode in the treatment of neonatal respiratory distress syndrome and to compare the treatment effect and the incidence of complications and whether it can reduce the time to go to the hospital and the number of hospital stays. Methods. Seventy-four children with RDS treated in hospital were selected and divided into the noninvasive high-frequency group (NHFV group, 36 children) and noninvasive positive pressure ventilation group (NCPAP group, 38 cases), and they were compared with the changes in arterial blood gas, the occurrence of complications, and the time on the machine before and after the operation on 12, 24, 48, and 72 hours. Results. In the NHFV group, PO2, a/APO2, and SaO2 were higher than those in the NCPAP group at 12, 24, 48, and 72 h after the respiratory support was given, and the differences were statistically significant (all P < 0.05 ). PaCO2 in the NHFV group was given respiratory support. After support, the results at 12, 24, 48, and 72 h were lower than those in the NCPAP group, and the difference was statistically significant (both P < 0.05 ). The children in both groups were cured and discharged from the hospital, with air leakage, persistent pulmonary hypertension, and bronchopulmonary dysplasia; there were no statistically significant differences in the incidence of complications such as retinopathy, pulmonary hemorrhage, and intracranial hemorrhage ( P > 0.05 ). The NHFV group had less tracheal intubation, operation time, and hospital stays than the NCPAP group. The differences were significant. Statistical significance was at P < 0.05 . Conclusion. Noninvasive high-frequency ventilation is effective in the treatment of RDS, and compared with the CPAP ventilation mode, it can reduce CO2 retention, increase the oxygenation index, and reduce time of operation and length of hospital stay in children with RDS. It is worthy of clinical promotion and application.

scholarly journals Bubble CPAP (Continuous Positive airway pressure) therapy as a primary mode of respiratory support in preterm newborns with mild to moderate respiratory distress syndrome

2021 ◽  
Vol 8 (2) ◽  
pp. 94-99
Author(s):  
Dr. Sanjivani Deepak Maslekar ◽  
◽  
Dr. Somaiah G ◽  
Dr. Nagapraveen Veerapu ◽  
◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Respiratory Support ◽  
Pressure Therapy ◽  
Primary Mode ◽  
Antenatal Steroids ◽  
Bubble Cpap ◽  
Preterm Newborns

Background: Respiratory distress syndrome (RDS) is an important cause of morbidity and mortalityin preterm infants. Bubble CPAP when used appropriately, is more cost-effective, non-invasive,requires less training and has a lower risk of complications. However, not all preterm infants withRDS respond to CPAP. Aims: To study the immediate outcome of preterm infants with mild tomoderate respiratory distress syndrome on Bubble CPAP. To study the safety and effectiveness of B-CPAP and to identify the risk factors associated with its failure. Setting: NICU, Department ofpediatrics, Mamata general hospital and medical college, Khammam. Design- Prospectiveobservational study Material and Methods: This duration bound study was conducted fromFebruary 2018 to February 2020. Based on the inclusion criteria 73 Preterm babies with mild tomoderate respiratory distress syndrome requiring respiratory support were included in this study.Details of birth history, use of antenatal steroids, gestational age, type of delivery, birth weight,Downes score and chest X-ray were recorded. And the effectiveness and outcome of bubble CPAPwere studied. Results: Out of the total of 73 cases, 53(72.60%) were treated successfully, while20(27.40%) failed bubble CPAP. Conclusion: Bubble CPAP is the safe primary mode of respiratorysupport in Preterm newborns with mild to moderate RDS, more effective with early Initiation and inPreterm babies born to mothers with the use of antenatal steroids.

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