Outcome Of Respiratory Distress Research Articles

Clinical Profile and Outcomes of Respiratory Distress in Neonates- A Cross Sectional Study

Background: Respiratory distress in neonates is a significant cause of morbidity and mortality worldwide. Understanding its prevalence and associated factors is crucial for effective management and preventive strategies. This cross-sectional study aimed to assess the prevalence and clinical profile and outcomes associated with respiratory distress in neonates admitted to the neonatal unit. Methods: Data were collected from neonates admitted to Miracle hospitals, medipally, Hyderabad, Paramitha hospitals, medipally, Hyderabad over period of 6 months. Clinical signs and symptoms of respiratory distress, demographic details, maternal history, and neonatal characteristics were recorded. Descriptive statistics were used to summarize the data, and multivariable logistic regression analysis was performed to identify independent predictors of respiratory distress. Results: 150 neonates included in the study those were diagnosed with respiratory distress. Preterm birth, low birth weight, maternal complications during pregnancy, and perinatal asphyxia were significantly associated with an increased risk of respiratory distress. Neonates born via cesarean section had a higher likelihood of respiratory distress compared to those born via vaginal delivery. Additionally, male gender and maternal smoking during pregnancy were identified as significant risk factors. The prevalence of Respiratory distress observed in males (60%) and in females (40%). Higher percentage of our study population belonged to the preterm babies (<38weeks). In the sample size of 150 patients, we observed 60 cases with TTNB, 40 Cases with HMD, 30 cases with MAS, 15 cases with congenital pneumonia & 5 cases with birth asphyxia. Conclusion: This study provides insights into the prevalence and associated factors of respiratory distress in neonates, highlighting the importance of early recognition and targeted interventions. Strategies targeting modifiable risk factors such as maternal smoking cessation and optimizing prenatal care may help reduce the burden of respiratory distress in neonates. Further research is warranted to explore additional factors and validate these findings in diverse settings.

Characteristics and outcomes of respiratory distress among term infants born in a regional setting.

Respiratory distress is the leading cause of admission to neonatal units and is a common indication for medical retrieval. Whilst approximately 25% of births in NSW occur in regional centres, there is a paucity of neonatal research in these settings. To describe the characteristics and outcomes of term neonates admitted with respiratory distress to two regional special care nurseries (SCNs) and identify variables associated with the need for medical retrieval. We describe a cohort of 629 term infants admitted to the SCN in two regional hospitals, 2015-2019. We describe the admission characteristics, level of respiratory support, biochemical investigations, diagnosis and outcomes. During the study period, 629 eligible term infants were admitted, retrieval occurred in 29 (4.6%). Those admitted were more often male (66.5%), with a mean gestational age of 39 + 1 weeks (±9 days) and birth weight of 3470 g (±500 g). Infants requiring medical retrieval had higher PaCO2 on blood gas analysis (59.8 mmHg vs. 53.3 mmHg, OR 1.03, p = 0.02). There was no association between maternal GBS status, meconium-stained liquor, gestational age, or raised inflammatory markers and medical retrieval. Transient tachypnoea of the newborn was the most common diagnosis of neonates admitted to SCN with respiratory distress. Among term infants admitted to a SCN for respiratory distress most were male, of a normal birthweight and born in good condition. Within our cohort there was no association between retrieval and maternal GBS colonisation, meconium-stained liquor or raised infectious biomarkers. Medical retrieval was infrequent and was associated with higher PaCO2 on initial blood gas analysis. We present a large cohort of term newborn infants managed for respiratory distress in a regional setting over a five-year period. Retrieval was infrequent, and outcomes for the cohort were excellent with no deaths during the study period.

Study of Risk Factors and Outcome of Respiratory Distress in Neonates Admitted In Neonatal Intensive Care Unit in a Tertiary Care Hospital

Study of Risk Factors and Outcome of Respiratory Distress in Neonates Admitted In Neonatal Intensive Care Unit in a Tertiary Care Hospital

Epidemiology and outcomes of respiratory distress in newborns

Respiratory distress of newborns is one of the most frequent causes of infant admission to intensive care units, the development of severe complications of the neonatal period and lethal outcomes.The objective was to study the epidemiology and outcomes of respiratory distress in newborns requiring intensive care measures.Materials and methods. The design was a retrospective observational study. We examined 180 newborns, the mean weight was 1620 (1075–2197.5) g, and the gestational age was 31.8 (29–34.5) weeks. Apgar score at minute 1 was 5 (4–7) and at minute 5 was 7 (6–7) scores. The duration of artificial lung ventilation was 2 (12.5–242) hours, and the duration of treatment in the NICU was 10 (6–19) days. Lethal outcomes occurred in 6 (3%) cases.Results. The most frequent cause of respiratory distress in newborns was respiratory distress syndrome in newborns (53%). The second place was occupied by asphyxia in childbirth (31%). Intra-amniotic infection was detected in 11 (6%) newborns, and intrauterine pneumonia in 5 (3%) infants. Transient tachypnea was registered in 6 (3%) newborns, and meconium aspiration syndrome – in 8 (4%) patients. In premature infants, the most severe course of respiratory distress was noted in pneumonia and asphyxia, in mature infants – in meconium aspiration syndrome. The maximum duration of intensive care measures was observed in intra-amniotic infection – 16 days and respiratory distress syndrome – 11 days. The outcome in 47% was favorable – complete recovery. Unfavorable outcomes included intraventricular hemorrhage (12%), combination of two or more complications (20%), bronchopulmonary dysplasia (5%), and persistent arterial ductus (4%).Conclusion. The outcome of respiratory distress in newborns with adequate assessment of the severity of the condition and timely initiated evidence-based treatment is determined not by the main clinical diagnosis, but by the gestational age and severity of the infant condition at the time of birth.

“A STUDY TO CORRELATE RISK FACTORS AND OUTCOMES WITH MORBIDITY AND MORTALITY PATTERN OF RESPIRATORY DISTRESS IN NEONATES IN NICU OF A TERTIARY CARE CENTRE IN RURAL SETUP”

Background: One of the most frequent illnesses in the rst 48 to 72 hours of neonatal life is respiratory distress. The most frequent reason for NICU hospitalization and the leading cause of morbidity in newborn is respiratory distress. The present study is aimed to determine and correlate the incidence, risk factors, causes and outcomes of respiratory distress in neonates in a neonatal intensive care unit of a tertiary care facility. Impressive outcomes are achieved when neonatal respiratory illness is diagnosed early and managed with appropriate interventions. Material & Methods: A prospective observational study was conducted for a period of 18 months in the inborn & outborn NICU of Department of Pediatrics, Index Medical College Hospital & Research Centre, Indore after valid approval from Institutional ethics committee on. 100 babies who presented with respiratory distress irrespective of their status at time of delivery (preterm, term or post term) and qualied the inclusion criteria were enrolled after taking written informed consent from the parents/caretakers. Following the admission of the newborn, data were recorded in the predesigned proforma. Statistical analysis was done with P value <0.05 signicant. Out Results: of 100 babies included in the study, 62 were males while 38 were females. Pulmonary cause was the most frequent cause of respiratory distress in newborn out of which TTNB (33%) was the commonest followed by RDS (20%). Prematurity (37%), MSAF (18%), Caesarean section against precipitous labour (9.5%), obstruction/non progression of labour (8%) were the major risk factors to develop. 58% of babies were born via LSCS with MSAF (24.1%), previous Caesarean section (20.7%) and obstructed labour (13.8%) as the main indications. Under treatment intervention,62 (62%) babies required only Oxygen while 20 babies (20%) required CPAP and 18 babies (18%) required mechanical ventilation. Morbidity was seen in 34% of newborns with RD which included sepsis, ROP, IVH, HIE, BPD. Out of 20 deaths,14 babies (70%) were males, and 6 babies (30%) were females. In Conclusion: cidence of respiratory distress was 9.8% among live births. Transient tachypnea of the newborn is the most common cause of respiratory distress in newborn. Antenatal risk factors increase the incidence of RD. Risk factors like Prematurity, meconium-stained liquor, cesarean delivered newborns, obstructed labour, Oligo/polyhydramnios, foetal distress, PROM was associated with respiratory distress in newborns. Prematurity is the most common and most important risk factor for the development of RD in newborn. There was male predominance & most of the babies were delivered via caesarean section. Frequency and severity of RD is inversely related to gestational age and birth weight. Early term and preterm babies constituted majority of the babies with respiratory distress. Most of the babies had mild to moderate respiratory distress with Downe's score between 2-6. RDS was the most common cause for CPAP and ventilation. The mortality rate was 20% among the respiratory distress cases admitted in NICU, rest 80% survived. The most common cause of death was RDS. Early diagnosis and identication of causes of respiratory distress in neonate is critical in the management. The neonatal outcome will improve with efforts made to prevent preterm birth, identify various maternal risk factors and intervene early with appropriate interventions.

Correlation between high serum ferritin levels and adverse pregnancy outcomes in women with gestational diabetes mellitus

AimsTo explore the association between higher serum ferritin (SF) levels in mid-pregnancy and adverse pregnancy outcomes in gestational diabetes mellitus (GDM) pregnancies, then develop a predictive cut-off value that might effectively predict the risk of adverse pregnancy outcomes in future clinical. MethodsThe study involved 201 pregnant women with GDM. 201 gestational age and parity matched normoglycemic pregnant women were taken as control group. The differences in clinical data were compared by the Mann-Whitney U test and Chi-square tests. Multivariate logistic regression was used to determine the relationship between SF and GDM-relate adverse pregnancy outcomes. The predicted value of SF level was determined through receiver operating characteristic (ROC) curve analysis. ResultsSF level was significantly higher in women with GDM [16.10 (27.30–9.50) (ng/mL) vs. 12.04 (18.11–7.06) (ng/mL), (p < 0.001)]. Meanwhile, higher levels of SF were also discovered in GDM women with preeclampsia and neonatal hypoglycemia and respiratory distress (all p < 0.05). In the adjusted model, a positive association was shown between SF and preeclampsia [adjusted odds ratio (AOR) = 1.032, 95%CI = 1.004–1.060, p = 0.024], neonatal hypoglycemia [adjusted odds ratio (AOR) = 1.047, 95%CI = 1.022–1.072, p < 0.001] and respiratory distress outcomes (AOR = 1.034, 95%CI = 1.011–1.058, p = 0.004) respectively. The area under ROC curve (AUC) for prediction of preeclampsia by SF combined with serum calcium, age, pre-pregnancy BMI and gestational weight gain (GWG) was 0.658 (95% CI = 50.8–80.8%, p = 0.028) with the cut-off value of 24.45 ng/mL, and the sensitivity and specificity were 58.8.0% and 64.3%, respectively. To predict neonatal hypoglycemia, the clinical point value of SF was 27.43 ng/mL with AUC was 0.800, sensitivity and specificity was 90.5% and 68.0% respectively. Predicting neonatal respiratory distress, the AUC value of the SF level was 0.730, with a cut-off value of 27.37 ng/mL and the sensitivity and specificity were 52.0% and 86.5%, respectively. ConclusionsHigher level of SF in mid-pregnancy was significantly associated with the risk of GDM and GDM-relate adverse pregnancy outcomes. Moreover, SF levels have moderate clinical value in predicting the adverse outcomes of maternal preeclampsia, neonatal hypoglycemia and respiratory distress.

A predictive model for respiratory distress in patients with COVID-19: a retrospective study.

BackgroundCoronavirus disease 2019 (COVID-19), associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global public health crisis. We retrospectively evaluated 863 hospitalized patients with COVID-19 infection, designated IWCH-COVID-19.MethodsWe built a successful predictive model after investigating the risk factors to predict respiratory distress within 30 days of admission. These variables were analyzed using Kaplan-Meier and Cox proportional hazards (PHs) analyses. Hazard ratios (HRs) and performance of the final model were determined.ResultsNeutrophil count >6.3×109/L, D-dimer level ≥1.00 mg/L, and temperature ≥37.3 °C at admission showed significant positive association with the outcome of respiratory distress in the final model. Complement C3 (C3) of 0.9–1.8 g/L, platelet count >350×109/L, and platelet count of 125–350×109/L showed a significant negative association with outcomes of respiratory distress in the final model. The final model had a C statistic of 0.891 (0.867–0.915), an Akaike’s information criterion (AIC) of 567.65, and a bootstrap confidence interval (CI) of 0.866 (0.842–0.89). This five-factor model could help in early allocation of medical resources.ConclusionsThe predictive model based on the five factors obtained at admission can be applied for calculating the risk of respiratory distress and classifying patients at an early stage. Accordingly, high-risk patients can receive timely and effective treatment, and health resources can be allocated effectively.

Prevalence and Outcome of Respiratory Distress in Newborn- A Tertiary Care Hospital Experience

Prevalence and Outcome of Respiratory Distress in Newborn- A Tertiary Care Hospital Experience

Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 - March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of 38% to 62% whereas 24 (39%) babies required mechanical ventilation and other modalities. This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

Clinical profile and outcome of respiratory distress in newborns admitted in rural tertiary health care centre of Maharashtra, India

Background: Respiratory distress is most common symptom complexes seen in newborn infants lead to high mortality. The objectives were to study various etiological factors, maternal and neonatal risk factors for development of respiratory distress along with need for CPAP, mechanical ventilation and surfactant to assess the immediate clinical outcome in newborns.Methods: The study was conducted at Krishna Hospital and Medical Research Centre, Karad in period of January to August 2018. A total of 100 neonates who were admitted in NICU within 72 hours of life were studied by clinical examination and relevant investigations. The severity of distress was assessed by Silverman-Anderson scoring, Downe’s scoring and APGAR scoring respectively for neonates.Results: It was observed that max, 90% of the distress cases were of respiratory in origin and high severity of distress was observed among 27% newborns. The proportion of respiratory distress was higher, 51% in males and low APGAR score was reported in 14% cases. Among respiratory etiology of respiratory distress, high proportion was of TTNB 35.55%. The maternal and new born factors like maternal age &gt;30 years (32%), gestational age 28-30 weeks (87.5%), gravid 2 and 3 mothers (35%), female gender (32.6%), low birth weight (70%) developed severe distress respectively. The recovery rate of respiratory distress due to respiratory etiology was of 88.8%.Conclusions: Transient tachypnoea of new-born is the most common cause among new-borns with respiratory distress. New-borns with low gestational age, low birth weight baby, low APGAR score is more prone to develop severe respiratory distress.

Study of Clinical Outcome of Respiratory Distress in Newborn

Study of Clinical Outcome of Respiratory Distress in Newborn

Causes and Outcomes of Respiratory Distress in Neonates Hospitalized in the Neonatal Intensive Care Unit of Be’sat Hospital in Hamadan, Iran

Background Neonatal respiratory distress is one the most common problems in the first few day of neonatal life. The present study intended to determine the frequency of the causes and outcomes of respiratory distress in neonates hospitalized in the neonatal intensive care unit (NICU) in Hamadan city, Iran. Materials and Methods In this descriptive and cross-sectional study, all the neonates with respiratory distress (RD), who were hospitalized in the NICU of Be’sat Hospital in Hamedan city, Iran, during 2014 to 2015, entered the study. The required demographic information was extracted from patients’ dossiers. The collected data were analyzed using SPSS version 16.0. Results The mean neonatal age upon admission, mean gestational age and mean birth weight were 5.22±7.18 days, 36.58±3.54 weeks and 2743.9±727.9 grams, respectively. According to the results, intercostal retraction (75.3%), tachypnea (67.7%), and grunting (61.3%) were the most common symptoms of neonatal respiratory distress (NRD), while respiratory distress syndrome (RDS) (36.6%), pneumonia (30.1%), and transient tachypnea of the newborn (TTN) (%14), were the most common causes of respiratory distress. Furthermore, about 19.3% of the neonates died of the disease. The results of logistic regression for the independent risk factors associated with RD outcomes showed that the death rate of neonates with RD had a significant correlation with respiratory failure requiring mechanical ventilation (odds ratio[OR]: 33.49, 95% confidence interval [CI]: 6.95-161.38), and incidence of apnea (OR: 5.87, 95% CI: 1.072-32.167). Conclusion It was found that RDS is the most common cause of respiratory distress in the hospitalized neonates. Moreover, infant mortality rate increased due to respiratory failure requiring mechanical ventilation and occurrence of apnea.

Study of respiratory distress in newborn

Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevalence of neonatal respiratory distress in our area. It was conducted for a period of two years from 1st August 2014 to 31st July 2016.Results: maximum admissions on day 1 of life i.e. 309 (77.25%) followed by on day 2 i.e. 90 (22.50%) 231 (57.75%) were males and 169 (42.25%) were females. Male to female ratio was 1.36:1 Out of 400 children 11 were less than 1000 gms, followed by 77 (19.25%) had birth weight between 1000 g - 1499 g, 193 (48.25%) neonates had weight between 1500 g - 2499 gms and 118 (29.5%) neonates had weight between 2500 - 3499 gms and remaining 1 neonate had birth weight &gt; 3500 grams. Out of 400 Neonates with respiratory distress, 281 (70.25%) had low birth weight and remaining 119 (29.75%) neonates had normal birth weight.Conclusions: Respiratory distress was the major cause of admission in our NICU. Caesarean section was the most common predisposing factor associated with the development of respiratory distress in neonates. Antenatal risk factors increase the incidence of RD. The most common causes of respiratory distress were TTN, RDS, MAS, and perinatal asphyxia. The common cause of death was HMD. The outcome of neonatal respiratory distress was found as: a survival rate of 78.5%, mortality rate of 21.5%.

Spectrum of respiratory distress in very low birthweight neonates.

The incidence, etiology and the outcome of respiratory distress in 243 consecutive liveborn very low birth weight neonates (VLBW) were analysed. One hundred and forty six (60%) VLBW neonates developed respiratory distress. Hyaline membrane disease, congenital pneumonia and transient tachypnea of the newborn were the major underlying causes (35.6%, 28.1%, and 27.4% respectively). The mortality rate was significantly higher in neonates with respiratory distress (72 of 146, 49.3%) than in those without distress (28 of 97, 28.8%) (p < 0.05). This difference was more sharply reflected in the 1000-1249 birth weight group and in the 29-32 weeks gestation group. Respiratory distress is a significant determinant of VLBW mortality.

Epidemiology of respiratory distress of newborns.

The present prospective study was conducted to find out the incidence, etiology and outcome of respiratory distress (RD) in newborns. All newborns (n = 4505), delivered at this hospital over a period of 13 months, were observed for respiratory problems. Relevant antenatal, intranatal and neonatal information was noted. Cases were investigated for the cause of respiratory distress and followed up for the outcome. The overall incidence of RD was 6.7%. Preterm babies had the highest incidence (30.0%) followed by post-term (20.9%) and term babies (4.2%). Transient tachypnea of newborn (TTN) was found to be the commonest (42.7%) cause of RD followed by infection (17.0%), meconium aspiration syndrome (10.7%), hyaline membrane disease (9.3%) and birth asphyxia (3.3%). TTN was found to be common among both term and preterm babies. While Hyaline membrane disease (HMD) was seen mostly among preterms, and Meconium aspiration syndrome (MAS) among term and post-term babies. Overall case fatality ration for RD was found to be 19%, being highest for HMD (57.1%), followed by MAS (21.8%) and infection (15.6%). Our results indicate that RD is a common neonatal problem. TTN accounts for a large proportion of these cases. MAS and infection also contribute significantly and are largely preventable. Without adequate ventilatory support HMD and MAS carry high mortality.