scholarly journals Mechanical Ventilation in Neonatal Respiratory Distress Syndrome at High Altitude: A Retrospective Study From Tibet

2019 ◽  
Vol 7 ◽  
Author(s):  
Dan Chen ◽  
Xiuxiu Liu ◽  
Jiujun Li
2020 ◽  
Author(s):  
Qiu-xia Jiang ◽  
Li-jing Shi ◽  
Long-yuan Shen ◽  
Xiao-qing Li ◽  
Rong-sen Hung ◽  
...  

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.


Author(s):  
Aleksandar G. Kočović ◽  
Gordana D. Kostić ◽  
Dragana M. Savić ◽  
Milica M. Stanojević ◽  
Miloš N. Milosavljević ◽  
...  

Abstract Neonatal respiratory distress syndrome (NRDS) is a consequence of immaturity at birth and it is still associated with relatively high mortality rate. The aim of this study was to identify the factors associated with the occurrence of fatal outcome in newborns with neonatal respiratory distress syndrome.The research was designed as a case-control study nested in a retrospective cohort, and it enrolled newborns treated during 2015 at Pediatric Clinic of Clinical Center in Kragujevac. Diagnosis of NRDS and decision about the treatment were left at the discretion of attending pediatricians. The cases were patients with fatal outcome, while controls were randomly selected from the pool of survivors and matched with each case by gender in a ratio of 4:1. The study included 371 newborns, of whom 201 (54.2%) were male and 170 (45.8%) female. Lethal outcome occurred in 36 newborns (9,7%). Significant association was found between death and APGAR score (ORadjusted: 0.516, 95% CI: 0.322-0.827), weight on delivery (ORadjusted: 0.996, 95% CI: 0.993-0.999), duration of hospitalization (ORadjusted: 0.901, 95% CI: 0.835-0.972) and mechanical ventilation (ORadjusted: 165.256, 95% CI: 7.616-3585.714). Higher gestational age, higher birth weight, higher APGAR score and longer duration of hospitalization were singled out as protective factors, while use of mechanical ventilation increased the risk of death. Major limitations of the study were retrospective nature and relatively small number of identified cases. Postponing delivery and delivery in institution with neonatal intensive care unit are crucial for survival of newborns with NRDS.


2019 ◽  
Vol 134 ◽  
pp. 19-25 ◽  
Author(s):  
Beena G. Sood ◽  
Josef Cortez ◽  
Madhuri Kolli ◽  
Amit Sharma ◽  
Virginia Delaney-Black ◽  
...  

1987 ◽  
Vol 28 (4) ◽  
pp. 389-394 ◽  
Author(s):  
W. Mortensson ◽  
G. Noack ◽  
T. Curstedt ◽  
P. Herin ◽  
B. Robertson

Ten newborn babies with severe respiratory distress syndrome, all dependent on artificial ventilation, were treated via the airways with the isolated phospholipid fraction of bovine or porcine surfactant. After treatment with surfactant at a median age of 10.5h, there was in all patients a striking improvement of lung aeration in chest films, with a decrease in parenchymal fluid retention and in distension of bronchioli. These radiologic findings were associated with a dramatic improvement of oxygenation and a significant reduction of the right-to-left shunt. In spite of the rapid therapeutic response, four patients died from cerebral hemorrhage. One of the surviving patients developed bronchopulmonary dysplasia. Our findings document efficacy of this new surfactant preparation in the neonatal respiratory distress syndrome, but the long-term effects need to be further tested in randomized clinical trials.


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