Neonatal Respiratory Distress Syndrome in a Nutshell

Respiratory distress syndrome (RDS) is an important cause of mortality and morbidity in preterm neonates. With the increasing number of preterm deliveries globally according to the World Health Organization, it is imperative to consider a safe place for delivery and a good obstetric care to start with. Antenatal steroids are helpful not only in reducing the risk of RDS but also reducing necrotizing enterocolitis (NEC) and Intraventricular hemorrhage which further improves the outcome of a preterm delivery. Delayed cord clamping is recommended as it reduces mortality in preterm newborns. Use of optimal oxygen and getting CPAP into the delivery room has improved the outcome and reduced the need of mechanical ventilation thus reducing the risk of Chronic Lung Disease (CLD). Timing the administration of surfactant is important to avoid mechanical ventilation. The increasing use of non-invasive ventilation has reduced ventilator induced lung injury and CLD. Many have embraced Heated Humidified High Flow Nasal Oxygen (HHHFNC) as an alternative to CPAP and its use has increased in view of its ease of use and lesser trauma. Caffeine facilitates early extubation in intubated preemies on ventilators and improves neurodevelopment outcome. Adequate nutrition and proper temperature control starting from the point of delivery cannot be emphasized enough for this group of population.

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Comparison between nasal continuous positive airway pressure and mechanical ventilation after surfactant administration in preterm neonates with respiratory distress syndrome

Alexandria Journal of Pediatrics ◽

10.4103/ajop.ajop_15_19 ◽

2019 ◽

Vol 32 (1) ◽

pp. 33

Author(s):

HassanH Hassan ◽

HeshamA Ghazal ◽

MohammedE.A El-Khouly

Keyword(s):

Mechanical Ventilation ◽

Continuous Positive Airway Pressure ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Airway Pressure ◽

Distress Syndrome ◽

Positive Airway Pressure ◽

Preterm Neonates ◽

Surfactant Administration

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Study Of The Outcome Of Early And Late Rescue Surfactant Administration In Preterm Babies

Asian Journal of Health Sciences ◽

10.15419/ajhs.v2i2.408 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Jayachandra Naidu T ◽

Kireeti AS ◽

Lokesh B ◽

Shankar Reddy Dudala

Keyword(s):

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Surfactant Therapy ◽

Preterm Neonates ◽

P Value ◽

Surfactant Replacement Therapy ◽

Preterm Babies ◽

Surfactant Administration

Introduction: Respiratory Distress Syndrome (RDS) is a common cause of mortality and morbidity in preterm. It is the commonest indication for ventilation in neonates in India. Surfactant Replacement Therapy (SRT) for RDS is a major breakthrough that has revolutionized the survival of premature infants worldwide. Randomized controlled trials have also demonstrated that prophylactic or early surfactant therapy compared with delayed surfactant treatment results in improved outcomes for preterm infants at high risk. Objective: To assess the outcome of early and late rescue surfactant administration by InSuRE (Intubation, Surfactant and Rapid Extubation) technic in managing preterm neonates with respiratory distress syndrome (RDS). Methodology: Study design: Prospective analytical study. Sample size: 144 preterm babies between 28-34 weeks of GA. Setting: Level III NICU at SVRR Government General Hospital, Tirupati, AP. Study Period: 1 year (Sep 2013 to Aug 2014). Method: All preterm babies between 28-34 weeks with respiratory distress were given surfactant with InSuRE technic immediately and categorized into early and late rescue group depending on the time of surfactant therapy i.e. within 2 hrs. of life and between 2-24 hrs. of life respectively. Results: In early rescue group there is significant reduction in mortality and lessen the need of mechanical ventilation with p value <0.05. Conclusion: Early routine surfactant administration within 2 hrs. of life as compared to late selective administration significantly reduced the need mechanical ventilation within 7th day of life and mortality among preterm with respiratory distress syndrome.

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USE OF EARLY NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN TREATMENT OF PRETERM NEONATES WITH HYALINE MEMBRANE DISEASE (NEONATAL RESPIRATORY DISTRESS SYNDROME)

10.36106/ijsr/2123779 ◽

2021 ◽

pp. 15-17

Author(s):

Ranjeet Kumar ◽

Aarti Sharma ◽

Falak Naaz ◽

Zeeshan Ahmed

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Severe Disease ◽

Effective Means ◽

Neonatal Respiratory Distress Syndrome ◽

Respiratory Support ◽

Preterm Neonates ◽

Antenatal Steroids ◽

Neonatal Respiratory Distress

Objective:To evaluate the outcome of early nasal CPAPin premature neonates with neonatal respiratory distress syndrome. Methods: 100 babies of 28-34 weeks gestational age admitted in Neonatal ICU of Nalanda Medical College & Hospital, Patna (Bihar, India), with clinical diagnosis of HMD, requiring respiratory support were treated with early nasal CPAPand studied prospectively from 1st November 2014 to 31st October 2016. Results: We found a success rate of 80% in babies with HMD, who were managed with early nasal CPAPalone. Remaining 20% needed intubation and higher mode of ventilation. Mild and moderate grade HMD were effectively managed with early nasal CPAP (P<0.05). It was also found to be effective in babies of mothers who have received antenatal steroids (P<0.05). Conclusion: Prematurity is the commonest predisposing cause for HMD. Early nasal CPAPis safe, inexpensive and effective means of respiratory support in HMD. It is useful in mild and moderate grade disease. It may not be a replacement for assisted ventilation in severe disease. It is also found to be more effective in babies of mothers who have received antenatal steroids.

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Relation of asymmetric dimethylarginine with pulmonary morbidities in neonatal respiratory distress syndrome

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200604 ◽

2021 ◽

pp. 1-7

Author(s):

N.T. Abed ◽

O.M. Abdelhaie ◽

E.R.A. Almonaem ◽

A.I. Mansour

Keyword(s):

Nitric Oxide ◽

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Preterm Infants ◽

Distress Syndrome ◽

Elevated Serum ◽

Preterm Neonates ◽

Adma Level ◽

Surfactant Treatment

BACKGROUND: Asymmetric Dimethyl Arginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS) is important in different diseases characterized by decreased nitric oxide (NO) availability. We aimed to assess the serum ADMA level in preterm infants suffering from respiratory distress syndrome (RDS) and its relationship with pulmonary outcomes. METHODS: This prospective study included 50 preterm neonates suffering from RDS aging≤32 weeks and weighing≤1500 gm. Serum ADMA levels were estimated in the 1st and 28th day of life by ELISA, and its correlation with surfactant requirement, duration of ventilation, and development of BPD was assessed. RESULTS: Fifty preterm infants with RDS were included, 30 infants were treated with surfactant within 12 hours after birth, the 1stday ADMA level was higher significantly in infants who required surfactant treatment than infants without surfactant treatment, At 36 weeks postmenstrual age, 16 infants were diagnosed with BPD, the 28th day ADMA level was significantly higher in infants with BPD than others without BPD. 1st-day ADMA level was significantly correlated with days on mechanical ventilation but there were no significant correlations between 1st day ADMA and days on CPAP and days on supplemental O2. CONCLUSION: Elevated serum ADMA level in preterm neonates with RDS estimated in the 1st and 28th day of life is a good predictor for pulmonary morbidities such as surfactant requirement, duration of mechanical ventilation, and development of BPD.

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Comparison between two natural surfactant poractant alfa and bovine lipid extract in respiratory distress syndrome amongst preterm neonates-a quasi-experimental study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20214848 ◽

2021 ◽

Author(s):

Srikanta Baske ◽

Sudip Saha ◽

Partha Pratim Pal

Keyword(s):

Experimental Study ◽

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Tertiary Care ◽

Preterm Neonates ◽

Care Hospital ◽

Oxygen Requirement ◽

Quasi Experimental

Background: A comparison study of two natural surfactants in preterm babies admitted in neonatal intensive care unit (NICU) and sick newborn care unit (SNCU) of a tertiary care hospital to find out efficacy and consequences.Methods: A Quasi-experimental study. InSurE technique applied for administering Poractant alfa (CUROSURF) and bovine surfactant (NEOSURF) in two comparison group of preterm neonates with respiratory distress syndrome (RDS) during May 2018 to April 2019. The need of mechanical ventilation, oxygen requirement (FiO2), duration of oxygen requirement and the consequences were assessed.Results: The CUROSURF is 6.67% more efficacious than NEOSURF in respect to less requirement of mechanical ventilation. The differences were found between two groups in terms of FiO2adjusted (33.49% vs 37.17%) and common side effects respectively but the difference of mean duration of oxygenation (69.8 hrs vs 111.9 hrs) was less and statistically significant in CUROSURF group. Mean duration of hospitalization (9.55 day’s vs 14.9 days) also were found to be less and statistically significant.Conclusions: Treatment with CUROSURF was associated with faster improving oxygenation, less additional doses, and decreased need of mechanical ventilation.

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