scholarly journals Thromboelastometry in Neonates with Respiratory Distress Syndrome: A Pilot Study

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1995
Author(s):  
Georgios N. Katsaras ◽  
Rozeta Sokou ◽  
Andreas G. Tsantes ◽  
Aikaterini Konstantinidi ◽  
Dimitra Gialamprinou ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Multivariable Logistic Regression Analysis ◽  
Extrinsic Pathway ◽  
Term Neonates ◽  
Rotational Thromboelastometry ◽  
Significant Prolongation ◽  
Clot Formation Time ◽  
Maximum Clot Firmness

Background: Although respiratory distress syndrome (RDS) constitutes a postnatal risk factor for bleeding and thromboembolic events in neonates, few studies have addressed this issue. We aimed to evaluate the hemostatic profile of neonates with RDS using rotational thromboelastometry (ROTEM). Methods: An observational study was conducted from November 2018 to November 2020 in the NICU of General Hospital of Nikaia “Aghios Panteleimon”. Preterm and term neonates with RDS hospitalized in the NICU were included and EXTEM (tissue factor-triggered extrinsic pathway), INTEM (ellagic acid activated intrinsic pathway), and FIBTEM (with platelet inhibitor cytochalasin D) assays were performed at the onset of the disease. Results: A hypocoagulable profile was noted in neonates with RDS compared to controls, expressed as significant prolongation of EXTEM CT (clotting time) and CFT (clot formation time), lower EXTEM A10 (amplitude at 10 min), MCF (maximum clot firmness), and LI60 (lysis index). Furthermore, prolongation of INTEM CFT and FIBTEM CT, and decreased INTEM and FIBTEM A10 and MCF were found in neonates with RDS. Multivariable logistic regression analysis showed that RDS is an independent factor for the recorded alterations in ROTEM variables. Conclusions: RDS is associated with a hypocoagulable profile and greater hyperfibrinolytic potential compared to healthy neonates.

Pre-Existing Psychiatric Illness Is Associated With an Increased Risk of Delirium in Patients With Acute Respiratory Distress Syndrome

2021 ◽  
pp. 088506662110190
Author(s):  
Saminder Singh Kalra ◽  
Johnny Jaber ◽  
Bashar N. Alzghoul ◽  
Ryan Hyde ◽  
Sarina Parikh ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Psychiatric Illness ◽  
Distress Syndrome ◽  
Multivariable Logistic Regression Analysis ◽  
Psychiatric Illnesses ◽  
Increased Risk ◽  
Icu Delirium ◽  
The Impact

Background: Patients with acute respiratory distress syndrome (ARDS) are highly susceptible to developing delirium for a multitude of reasons. Previous studies have linked pre-existing depression with an increased risk of postoperative delirium in patients undergoing cardiac and non-cardiac surgery. However, the evidence regarding the association between pre-existing psychiatric illnesses and delirium in ARDS patients is unknown. In this study, we aim to determine the relationship between pre-existing psychiatric illness and the risk of development of delirium amongst ARDS patients. Study Design and Methods: We performed a retrospective study of a mixed group of patients admitted to the intensive care unit (ICU) between January 2016 and December 2019 with a diagnosis of ARDS per the Berlin definition. The study group was divided into 2 cohorts: subjects with delirium and subjects without delirium. Comparison between the 2 groups was conducted to examine the impact of pre-existing psychiatric illnesses including major depressive disorder (MDD), generalized anxiety disorder (GAD), bipolar disorder, schizophrenia, or post-traumatic stress disorder. Multivariable logistic regression analysis was performed adjusting for benzodiazepine use, sedatives, analgesics, sequential organ failure assessment score, and corticosteroid use to determine the association between pre-existing psychiatric disorders and delirium. Results: 286 patients with ARDS were identified; 124 (43%) of whom were diagnosed with ICU delirium. In patients diagnosed with ICU delirium, 49.2% were found to have preexisting psychiatric illnesses, compared to 34.0% without any preexisting psychiatric illness (OR = 1.94, P = 0.01). In a subgroup analysis of individual psychiatric illnesses, GAD and MDD were associated with the development of delirium (OR = 1.88, P = 0.04 and OR = 1.76, P = 0.05 respectively). Interpretation: ARDS patients with preexisting psychiatric illnesses, particularly GAD and MDD are associated with an increased risk of developing ICU delirium. Clinicians should be aware of the effect of psychiatric co-morbidities on developing delirium in critically ill patients.

Shunts in Patients With Respiratory Distress Syndrome

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 738-738
Author(s):  
FRANS J. WALTHER ◽  
JOHN O. LEIGHTON
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Full Term ◽  
Persistent Pulmonary Hypertension ◽  
Term Neonates ◽  
Premature Neonates ◽  
Group 4 ◽  
Study Population

In Reply.— We agree with Dr Evans that bidirectional ductal shunting is more common than net right-to-left ductal shunting in premature neonates with severe RDS and persistent pulmonary hypertension. Our conclusion that large right-to-left shunts via the ductus are common findings in these cases was not intended to exclude the presence of concomitant left-to-right shunting. In our study population the incidence of right-to-left ductal shunting at 12 and 24 hours of age was 86% and 94% in premature neonates with fatal RDS, 39% and 34% in the severe RDS group, 4% and 0% in the no/mild RDS group, and 6% and 0% in the full-term neonates without RDS.

scholarly journals 737: Nulliparity increases by 80% the risk for respiratory distress syndrome (RDS) in term neonates

2016 ◽  
Vol 214 (1) ◽  
pp. S386-S387 ◽  
Author(s):  
Jimmy Espinoza ◽  
Michael A. Belfort ◽  
Alex Vidaeff ◽  
Gary A. Dildy ◽  
Susan M. Ramin ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Term Neonates

scholarly journals Effect of Surfactant therapy on clinical outcome of Respiratory Distress Syndrome in premature neonates at French Medical Institute for Mother and Children

2020 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Preterm Neonates ◽  
Medical Institute ◽  
Term Neonates ◽  
Premature Babies ◽  
Healthy Infants

Respiratory distress syndrome (RDS) of the newborn, also known as Hyaline Membrane Disease, is a breathing disorder of premature babies. In healthy infants, the alveoli—the small, air-exchanging sacs of the lungs—are coated by surfactant, which is a soap-like material produced in the lungs as the fetus matures in preparation for birth. If premature newborns have not yet produced enough surfactant, they are unable to open their lungs fully to breathe. As the efforts, our hospital is to deliver health services in a best manner to have high quality of service delivery and a low number of mortality, although the RDS is high in Afghanistan, and there is no any reliable data, which show major causes death during in-bed hospitalization. Gradually increment of mortality rate of Respiratory Distress Syndrome at French Medical Institute for Mother and Children, based on observational and unreliable accurate data, is higher among preterm neonates versus term neonates. We are going to have a retrospective study, which will be the first study in Afghanistan in such area.

scholarly journals Hemodynamic Patterns Determined By Non-Invasive Cw-Doppler Ultrasound Cardiac Monitoring (USCOM) in Preterm Neonates with Respiratory Distress Syndrome During Non-Invasive Respiratory Support

2017 ◽  
Vol 8 (3) ◽  
pp. 41-46
Author(s):  
Vera A. Sergeeva ◽  
Yuri S. Alexandrovich ◽  
Denis M. Strelkov ◽  
Kseniya A. Siniuk
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Diastolic Dysfunction ◽  
Doppler Ultrasound ◽  
Distress Syndrome ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Term Neonates ◽  
Non Invasive ◽  
Bedside Method

Aim: To determine the hemodynamic patterns in preterm neonates with respiratory distress syndrome (RDS) using the USCOM-1A technology. Materials and Methods: The USCOM device is a bedside method of evaluating cardiac output (CO) based on continuous-wave Doppler ultrasound. Hemodynamic parameters were measured daily for 7 days in 32 preterm neonates 32 ± 1 weeks of gestation (1688 ± 111 g) with RDS requiring noninvasive respiratory support (NCPAP, NIPPV, HFNC) and no catecholamine support in comparison with 28 healthy term neonates (3100 ± 690 g). Results: At day 1, preterm neonates had lower SVI (18 ± 5 vs 28 ± 8 ml m-2, p = 0.043) and higher SVRI (1585 ± 245 vs 1035 ± 358 dyn s cm-5 m2, p = 0.013) with a tendency for lower cardiac index (2.6 ± 0.8 vs 4.0 ± 1.3 l min-1 m-2, p = 0.089). Together with no difference in SMII, it indicates the presence of diastolic dysfunction with low preload. It is noted that all parameters had not changed by day 7 in preterm neonates, whereas term neonates demonstrated significantly increased SMII reflecting postnatal cardiovascular adaptation. Compared with preterm neonates with RDS requiring NCPAP/NIPPV, preterm neonates requiring HFNC had higher levels of FTc (330 ± 59 vs 388 ± 41 ms, р = 0.045), SVI (13 ± 3 vs 18 ± 4, ml/m2, р = 0.007), SMII (0.41 ± 0.09 vs 0.57 ± 0.21, р = 0.02), and CI (2.2 ± 0.6 vs 4.5 ± 0.9 l/min/m2, р = 0.006). Conclusions:Noninvasive respiratory support in preterm neonates with RDS may lead to diastolic dysfunction that is less prominent in neonates with HFNC.

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