scholarly journals Immediate Outcome of Neonate With Pneumothorax

2015 ◽  
Vol 5 (1) ◽  
pp. 3-7
Author(s):  
Marium Begum ◽  
Zabrul SM Haque ◽  
Mahmuda Hassan ◽  
Abdul Mannan ◽  
Nasim Jahan
Keyword(s):  
Chest Tube ◽  
Needle Aspiration ◽  
Meconium Aspiration Syndrome ◽  
High Flow ◽  
P Value ◽  
Maternal Risk ◽  
X Ray ◽  
Life Saving ◽  
High Flow Oxygen ◽  
High Index Of Suspicion

Objectives : To determine the outcome of pneumothorax in term and post term neonates.Study Design : Neonates presented with respiratory distress and diagnosed pneumothorax by X-ray at the time of admission or during the course of hospital stay were included in this study.Results: Total 49 cases were included for the study, among them 29(59.18%)were male and 20(40.82%) female, 42(85%)babies cured and 7(15%)expired. Thirty-five (71.46%) delivered by LUCS, 14(28.57%) by NVD. Pneumothorax associated with maternal risk factors like UTI 10(21.2%), PROM 5(10.2%), GDM 2(4.2%)cases, PIH 1(2.0%), PET 1(2%), were observed. No maternal risk factor has been identified in 25(51%)cases and 4(8.1%)cases due to other reason. Nineteen neonates (38.77%) with meconium aspiration syndrome, 14(28.57%) required PPV, 10(20.40%) with pneumonia 2(4.08%) with congenital heart disease, 2(4.08%) with TTN, pneumothorax 2(4.02%). Total 40(81.63%) cases were in patient, only 3(7.5%) of them died, 9(18.36%) babies were out patient among them 4(8.16%) died, (P value Â0.001). Significant death were seen among those who admitted after 24 hours of age, 3 out of 6 cases). Four (8.16) out of 36(73.4%)expired who admitted before 24 hours of age, (P value  0.001.) Pneumothorax were managed by nitrogen wash out 29(59.18%), 5(10.20%) needle aspiration with high flow oxygen, 5(10.20%)needed needle aspiration, chest tube with high flow oxygen. Ten (20.40%)babies needed needling, chest tube drainage with ventilator, among them 6(12.24%)expired and 4 survived. No death were observed among the neonates who were managed with high flow oxygen.Conclusions: High index of suspicion, prompt diagnosis by cold light and urgent portable X-ray and immediate intervention is needed for life saving and better outcomeJ. Paediatr. Surg. Bangladesh 5(1): 3-7, 2014 (January)

scholarly journals Simple predictive models identify patients with COVID-19 pneumonia and poor prognosis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244627
Author(s):  
Mar Riveiro-Barciela ◽  
Moisés Labrador-Horrillo ◽  
Laura Camps-Relats ◽  
Didac González-Sans ◽  
Meritxell Ventura-Cots ◽  
...  
Keyword(s):  
Predictive Models ◽  
Poor Prognosis ◽  
High Flow ◽  
X Ray ◽  
Inflammatory Parameters ◽  
High Flow Oxygen ◽  
Patients At Risk ◽  
Chest X Ray ◽  
Bootstrap Replication

Background and aims Identification of SARS-CoV-2-infected patients at high-risk of poor prognosis is crucial. We aimed to establish predictive models for COVID-19 pneumonia severity in hospitalized patients. Methods Retrospective study of 430 patients admitted in Vall d’Hebron Hospital (Barcelona) between 03-12-2020 and 04-28-2020 due to COVID-19 pneumonia. Two models to identify the patients who required high-flow-oxygen-support were generated, one using baseline data and another with also follow-up analytical results. Calibration was performed by a 1000-bootstrap replication model. Results 249 were male, mean age 57.9 years. Overall, 135 (31.4%) required high-flow-oxygen-support. The baseline predictive model showed a ROC of 0.800 based on: SpO2/FiO2 (adjusted Hazard Ratio-aHR = 8), chest x-ray (aHR = 4), prior immunosuppressive therapy (aHR = 4), obesity (aHR = 2), IL-6 (aHR = 2), platelets (aHR = 0.5). The cut-off of 11 presented a specificity of 94.8%. The second model included changes on the analytical parameters: ferritin (aHR = 7.5 if ≥200ng/mL) and IL-6 (aHR = 18 if ≥64pg/mL) plus chest x-ray (aHR = 2) showing a ROC of 0.877. The cut-off of 12 exhibited a negative predictive value of 92%. Conclusions SpO2/FiO2 and chest x-ray on admission or changes on inflammatory parameters as IL-6 and ferritin allow us early identification of COVID-19 patients at risk of high-flow-oxygen-support that may benefit from a more intensive disease management.

scholarly journals Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Maternal Risk Factors ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
The Mean

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.

scholarly journals Role of Glycaemic Control in Predicting Severity of Illness in COVID 19 Patients with Diabetes Mellitus

2021 ◽  
Author(s):  
Jayanthi Hari Kishan ◽  
Vollala Shravan Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Glycaemic Control ◽  
Severity Of Illness ◽  
High Flow ◽  
P Value ◽  
Diabetic Patients ◽  
Poor Glycaemic Control ◽  
Non Invasive ◽  
High Flow Oxygen

Introduction: Coronavirus Disease 2019 (COVID 19) pneumonia is a rapidly spreading disease and which causes morbidity and mortality of many patients. Diabetes mellitus is co-morbidity which is considered as the risk factor for COVID 19. Well-controlled diabetes is associated with better outcomes than poorly controlled diabetes. Measurement of glycated haemoglobin (HbA1c) is the standard method for assessing long term glycaemic control. Regardless of the level of hyperglycaemia, improvement in glycaemic control will lower the risk of diabetic complications. Aim: This study was conducted to identify the role of glycaemic control (HbA1c) in predicting the severity of illness in patients with COVID 19 pneumonia. Materials and Methods: This was a retrospective observational study of (51 diabetic and 51 were non diabetic) patients at Kamineni Academy of Medical Sciences, Hyderabad, India. The patients diagnosed with COVID 19 pneumonia, which includes both diabetics and non diabetics from June 2020 to September 2020. Patients age, sex, baseline HbA1c levels, and oxygen requirement during the hospital stay were analysed using Statistical Package for the Social Sciences (SPSS) software version 22.0. The Chi-Square test was used to analyse qualitative data and p-value significant at level <0.05. Results: In the study among diabetics (n=51), 20 (39.2%) were on room air, 24 (47.1%) required intermittent oxygen support, 3 (5.9%) high flow oxygen, and 4 (7.8%) non invasive ventilator support. Among non diabetics (n=51), 28 (54.9%) were on room air, 18 (35.3%) on intermittent oxygen, 2 (3.9%) high flow oxygen, and 3 (5.9%) Non Invasive Ventilator (NIV) support. It was observed that patients with HbA1c measurements with poor glycaemic control required more oxygen support during treatment in diabetics (p-value:0.469) Conclusion: In the present study, patients with poor glycaemic control required insignificantly, more oxygen support than patients with good glycaemic control.

scholarly journals A study of profile of meconium aspiration syndrome in relation with birth weight and gestational age of newborns and their immediate outcome

2021 ◽  
Vol 8 (6) ◽  
pp. 1021
Author(s):  
Preeti Uniyal ◽  
B. P. Kalra ◽  
Sanober Wasim
Keyword(s):  
Birth Weight ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Maternal Diabetes ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
One Year

Background: Meconium aspiration syndrome (MAS) is one of the common causes of neonatal respiratory distress. Overall frequency of meconium stained amniotic fluid (MSAF) ranges between 5 to 25%.Methods: Observational study was conducted on 96 newborns over a period of one year in the department of pediatrics, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand. All newborns, inborns and outborns with MSAF admitted in NICU of our hospital were taken.  Results: Out of 876 babies those had MSAF, 96 babies developed MAS with 10.95% incidence. Common maternal risk factors noted with MAS was maternal diabetes mellitus in 11 (15.71%) cases. Babies born via LSCS developed MAS in 51 (53.12%) and in babies delivered vaginally 45 (46.87%). MAS occurred mainly in term with mean gestational age of 38 weeks with SD of 1.85 weeks. The mean birth weight of newborns with MAS was 2794 g with 524 g SD. Most common complication was birth asphyxia in 36 (37.5%). Mortality occurred in 11 (11.4%). Mean gestational age and birth weight of mortality in MAS was 38 weeks with 2.5 weeks SD and 2800 g with 723 g SD respectively. Statistically significant association noted between mortality due to MAS and birth weight as p value<0.05, but no significant association noted between mortality and gestational age.Conclusions: MAS is a common cause of respiratory distress in newborns born through MSAF. With judicious use of available modes of ventilation and adjunctive therapies, infants with even the most severe MAS can usually be supported through the disease, with an acceptable burden of short-and long-term morbidity.

High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

2020 ◽  
Vol 5 (4) ◽  
pp. 1006-1010
Author(s):  
Jennifer Raminick ◽  
Hema Desai
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Oxygen Therapy ◽  
Respiratory Illness ◽  
High Flow ◽  
Oral Feeding ◽  
Respiratory Support ◽  
Acute Respiratory Illness ◽  
High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

scholarly journals Thymic Carcinoid Tumour

2002 ◽  
Vol 9 (3) ◽  
pp. 215-216 ◽  
Author(s):  
Isabel Parra ◽  
Antonia Remacha ◽  
Serafín Costilla ◽  
José Antonio Santos Calderon
Keyword(s):  
Fine Needle Aspiration ◽  
Carcinoid Tumour ◽  
Needle Aspiration ◽  
Thymic Carcinoid ◽  
Fine Needle ◽  
X Ray ◽  
Carcinoid Tumours ◽  
Chest X Ray

Carcinoid tumours of the thymus are rare. The case of a 57-year-old asymptomatic man with a carcinoid tumour of the thymus, who showed a widened mediastinum by chest x-ray, is presented. Fine needle aspiration suggested the diagnosis, which was confirmed by biopsy.

scholarly journals Impact of flow and temperature on non‐dyspnoeic dogs' tolerance undergoing high‐flow oxygen therapy

2020 ◽  
Author(s):  
C. Harduin ◽  
B. Allaouchiche ◽  
J. Nègre ◽  
I. Goy‐Thollot ◽  
A. Barthélemy ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
High Flow ◽  
High Flow Oxygen
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