Clinical rationale for the treatment tactics of term patients diagnosed with transient neonatal tachypnoea without parenteral nutrition

N V Kalyakova,D S Dodrov,E V Shestak

doi:10.52420/2071-5943-2021-20-5-29-34

Abstract

Introduction. To analyze the efficacy and safety of treatment tactics for term patients diagnosed with TTN in an ICU without venous access and parenteral nutrition.Materials and methods. The study gives a retrospective analysis of the medical records of 241 ICU patients from January 2020 to March 2021. 83 children meet general criteria for inclusion in the study.Results and Discussion. While comparing the study group and the control group, no significant difference was detected in the incidence of risk factors during pregnancy and childbirth, such as gestational diabetes, ARVI during pregnancy, chorioamnionitis, preeclampsia, and the frequency of a prolonged anhydrous period, the frequency of induced labor, delivery by caesarean section, fetal distress and the use of vacuum extraction. Despite the same initial level of severity of respiratory disorders, when the child was admitted to the ICU, the duration of CPAP therapy was significantly higher in the control group: 7.5 (5.5-12) versus 5 (4-6) hours p = 5×10-5. The average length of hospital stay in the ICU and the total length of hospital stay was significantly higher in the control group (p = 4×10-11 and p = 0.006, respectively), as well as the need for treatment in the Neonatal Pathology unit conditions (p = 0.001).Conclusion. Analyzing the tactics of treating term patients diagnosed with TTN, the study proved that children without venous access require less time for respiratory therapy with CPAP in the NICU, the total duration of hospitalization in the NICU is significantly lower, as well as the need for additional treatment in the Neonatal Pathology unit. The study revealed that the early onset of enteral nutrition and the rapid expansion of the feeding portion, provided with child’s stable health condition, enable to avoid the installation of venous access and the prescription of parenteral nutrition at the ICU stage.

Highlights

To analyze the efficacy and safety of treatment tactics for term patients diagnosed with TTN in an ICU without venous access and parenteral nutrition
У доношенных пациентов с диагнозом ТТН без венозного доступа отмечались значимо более низкие длительность нахождения в ОРИТН и общая продолжительность госпитализации до выписки, что показано в ходе настоящего исследования и соответствует результатам крупных рандомизированных исследований иностранных коллег [31]
ЗАКЛЮЧЕНИЕ Результаты исследования показали клиническую обоснованность и эффективность выбора тактики ведения новорожденных с диагнозом ТТН без установки венозного доступа и назначения раннего парентерального питания

Summary

Introduction

To analyze the efficacy and safety of treatment tactics for term patients diagnosed with TTN in an ICU without venous access and parenteral nutrition. Наблюдение показало, что отказ от парентерального питания в течение первых 7 дней после поступления в ОРИТН приводит к меньшему количеству инфекций у новорожденных, снижению продолжительности госпитализации в отделения интенсивной терапии и стационаре в целом. Цель исследования — анализ эффективности и безопасности менее инвазивной тактики лечения доношенных пациентов с диагнозом ТТН в условиях отделения реанимации без установки венозного доступа и проведения парентерального питания.

Results

Conclusion