Risk Factor For Respiratory Distress Research Articles

A STUDY OF RISK FACTORS FOR THE DEVELOPMENT OF RESPIRATORY DISTRESS IN NEWBORN IN A TERTIARY CARE MEDICAL COLLEGE HOSPITAL IN EASTERN INDIA

Background:Respiratory distress is one of the commonest disorder encountered leading to hospital admission in neonates.Clinical presentation of respiratory distress in neonates include 2 or more of the following features- respiratory rate >=60/min, chest retractions, grunting, nasal aring, cyanosis. Early recognition and appropriate specic therapy of neonatal respiratory distress has impressive results. Aims and objectives: This study aimed to record risk factors for respiratory distress in neonates admitted in SNCU and NICU in a tertiary care medical college hospital. Material and Methods: The observational descriptive study included one hundred (100) newborns admitted in NICU and SNCU with clinical features of respiratory distress during 1 year study period in Malda Medical College and Hospital. Results: 68% neonates presented within 24 hrs of age. The occurrence of respiratory distress was high in male babies, 64% compared with female 36%.Several risk factors were associated with neonatal respiratory distress. Teenage pregnancy(44%), maternal anemia(73%), PIH (17%), antenatal fever(5%), APH (4%), GDM(8%), Thyroid disorders(11%) are present in varying degrees in mothers.RDS was the most common etiology, 32% followed by MAS(17%), TTNB(15%), CHD(15%), pneumonia(9%), birth asphyxia (7%), syndromic(2%).8 ELBWand 9 VLBWnewborns were all suffered from RDS.21 neonates born to teenage pregnancy developed RDS. Among preterm babies, RDS was the most common etiology, among term babies, TTNB was the commonest. Conclusion: Respiratory distress is one of the commonest cause of SNCU and NICU admission. RDS is common in preterm babies whereas TTNB is more common in term babies.Male gender, teenage pregnancy, low birth weight, gestational age, antenatal illness like PIH,GDM, thyroid disorders are the risk factors for neonatal respiratory distress.

The Interest of Non-Invasive Ventilation in The Management of Respiratory Pathology of Premature Newborns at Ehs Nouar Fadela

The rate of prematurity has increased markedly over the last 20 years. These preterm infants have a high risk of morbidity, especial respiratory, compared to full-term infants. Nasal continuous positive airway pressure (NCPAP) has significantly improved the prognosis of this respiratory distress (MMH). The objective: The objective of this work was to study risk factors and management of respiratory pathology in premature newborns at the EHS NOUAR FADELA. Patients and methods: This is a retrospective, descriptive, mono-centric study including all newborns having recourse to CPAP and managed in a level IIb maternity hospital at the E Nouar Fadela between January 2019 and June 2021. Pearson's Chi-squares were used for statistical testing. A p-value<0.05 represented a statistically significant difference. Results: We recorded 12633 deliveries of which 623 were preterm births representing 4.93% of births. For maternal characteristics: the average age was 29 ±5.57 years. Maternal morbidity was present in 20.9% gravidic hypertension and 11.7% gestational diabetes. Neonatal morbidity was dominated in preterm newborns was respiratory distress in 41.4%. Mechanical ventilation was necessary in 12.6% of cases. The two main causes of respiratory distress were MMH, maternal-fetal infection, respiratory distress, and respiratory failure. Significant risk factors for respiratory distress were gestational age, male sex and pre-labour caesarean birth (p<0.05). Conclusion: The use of NIV in newborns with respiratory distress is not negligible. Our results confirm the effectiveness of NIV. It is also essential to limit the use of pre-labour caesarean section to these terms whenever possible.

Analyses of abdominal adiposity and metabolic syndrome as risk factors for respiratory distress in COVID-19

BackgroundSeveral characteristics of the metabolic syndrome, such as obesity and hypertension, have emerged as risk factors for a poor clinical outcome in COVID-19. However, most reports lack data on the...

Different Causes of Respiratory Distress in Neonates at Different Gestational Ages in China: A Retrospective Multi-Center Cohort Study

Background: Pulmonary surfactant replacement therapy (SRT) is currently the main treatment for neonatal respiratory distress syndrome (NRDS), but not all infants, particularly late-preterm and full-term (LP/FT) infants, with NRDS can achieve a satisfactory outcome despite intensive care and SRT in China. Few studies have been done to investigate the risk factors associated with respiratory distress at different gestational ages to guide clinical treatment. Methods: Therapeutic effects of SRT(conventional dose) in infants at different gestational ages (GAs) were compared in a large retrospective multicenter cohort study performed in 26 neonatal intensive care units in China. The cause of respiratory distress was further analyzed by comparing the different risk factors closely related to NRDS severity at different GAs. Results: The study of 1240 infants with NRDS showed that SRT in a conventional dose was less effective in LP/FT infants than in early-preterm infants. Further analysis of the risk factors of respiratory distress revealed that a GA less than 30 weeks and a lack of prenatal corticosteroid use were closely related to NRDS severity in early-preterm infants, whereas perinatal infection- and perinatal hypoxia-associated risk factors were closely related to NRDS severity in LP/FT infants. Conclusion: The cause of respiratory distress in LP/FT infants might differ from that in early-preterm infants in China. Respiratory distress in early-preterm infants is mostly due to primary surfactant deficiency. However, respiratory distress in LP/FT infants is more likely related to perinatal infection and perinatal hypoxia. Funding: This trial was designed, organized, and implemented by the first author and the corresponding author’s research center. Public funding was obtained from the Emergency Project of the National Science Foundation of China (No. 81741065) and Scientific Research Projects Unit of Chongqing (Project-cstc2016shms-ztzx13001) (Project-cstc2015shmszx1201114). Declaration of Interest: None of the authors have conflicts of interest to disclose. Ethical Approval: The ethics committee of Daping Hospital approved the study protocols, according to the Chinese regulations for clinical investigation.

Analysis of Neonatal Respiratory Distress in Neonatal Intensive Care Unit at Nepal Medical College

Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit. However, studies of newborn admitted with respiratory distress in our setup are limited. This study aims to look for incidence of neonatal respiratory distress in our setup, to analyze the common causes of respiratory distress and to determine possible strategic plan needed for better clinical outcome. A cross sectional study was conducted from March 2013 to December 2014 in Nepal Medical College and Teaching Hospital. Data of all the neonates with respiratory distress admitted during this period were analyzed. Total 317 (13.4%) neonates were admitted to Neonatal Intensive Care Unit during the study period.109 neonates developed respiratory distress comprising 34.3% of all Neonatal Intensive Care Unit admissions. Incidence of neonatal respiratory distress was 4.6%. The common causes of respiratory distress in our study were meconium aspiration syndrome in 21.1%, septicemia in 16.5%, transient tachypnea of newborn in 15.5%, pneumonia in 14.6%, birth asphyxia and hyaline membrane disease were in each 11.9% of the neonates. Caesarean section was the most common predisposing factor associated with the development of transient tachypnea of newborn in 82.3% newborns (p=.001). The overall mortality rate due to respiratory distress was 12.8%. Meconium aspiration syndrome, septicemia and hyaline membrane disease are the most important causes of respiratory distress in our setup. Good obstetric care, proper training of health care personnel in neonatal resuscitation and early recognition of potential risk factors of respiratory distress will be helpful.

Preceding haemorrhagic shock as a detrimental risk factor for respiratory distress after excessive allogeneic blood transfusion.

Whether transfusion-associated circulatory overload arises as a simple result of over-transfusion or requires another trigger remains unclear. Here, we examined whether respiratory distress could be reproduced by massive transfusion alone in an animal model. A total of 20 anaesthetized swine were equipped with monitors. Allogeneic blood was obtained from 10 donor swine. A 4-stage loading protocol with each stage equivalent to 25% of the blood volume (BV) in the recipient swine was then used to infuse crystalloid (CR), hydroxyethyl starch (HES) or allogeneic blood (TR) (n=5 each). The five remaining animals were subjected to a haemorrhagic shock (HS) prior to an allogeneic blood transfusion (TRS). The PaO2 /FiO2 (P/F) ratio did not decrease to the level of respiratory distress in either the CR group or the HES group after loading with a volume corresponding to 100% of the recipient BV. However, the TRS and TR groups exhibited significant reductions in the P/F ratio after fluid overloading (227±29 and 267±133, respectively). Blood transfusion after HS expanded the blood volume, but over-transfusion alone did not. HS was accompanied by an increase in the white blood cell count. The lung and the heart can tolerate volume overloads with HES, CR and even transfused blood. However, a preceding HS may induce an inflammatory response, making the lung vulnerable to subsequent blood overloads. In this study, a preceding haemorrhagic shock mediated respiratory distress following massive transfusion in a swine model. (247 words).

Insulin treatment of maternal diabetes mellitus and respiratory outcome in late-preterm and term singletons

ObjectivesWhile the incidence of diabetes mellitus (DM) during pregnancy has been steadily increasing in recent years, the link between gestational DM and respiratory outcome in neonates has not been definitely...

Amniotic fluid lamellar body concentration as a marker of fetal lung maturity at term elective caesarean delivery

Caesarean birth, without prior labour, is associated with an increased risk of neonatal respiratory morbidity among term infants. The concentration of lamellar bodies in amniotic fluid reflects pulmonary surfactant production and release, and is thus used in preterm populations as a marker of fetal lung maturity. Whether amniotic fluid lamellar body concentration (AFLBC) may correlate with risk factors for term respiratory distress has not previously been evaluated. To determine the relationship between AFLBC and risk factors for respiratory distress following term caesarean birth. The AFLBC of 249 women at the time of term caesarean birth was examined for an association with gestational age, gender, presentation and neonatal respiratory distress requiring special care nursery (SCN) admission. There was a significant increase in AFLBC with gestation. When compared with caesarean deliveries performed during the 37th week of gestation, there was a 50%, 54% and 56% increase in lamellar body concentrations (LBCs) taken during the 38th, 39th and 40th week of gestation respectively (P < 0.05 for all). Female fetuses had a 16% higher LBC than males (P < 0.05). An LBC <100 x 10(9) mL(-1) was associated with increased risk of admission to the SCN with respiratory distress (RR = 5.6; 1.2-26.5, P < 0.05). Known risk factors for term respiratory distress are reflected in the AFLBC. A significant relationship exists between AFLBC and respiratory morbidity following term caesarean birth. However, the low prevalence of this condition limits the clinical role of AFLBC as a predictive test for term respiratory morbidity.

Devenir respiratoire à court terme d’une population d’enfants nés à 34, 35 et 36 SA dans une maternité de niveau III

The rate of infants born at 34-36 weeks gestation has increased over the last 10 years. These babies are at higher risk of morbidity and mortality than full-term infants. At present, prenatal steroids are given until 34 weeks. The purpose of this study was to present the epidemiologic data of the late preterm infants and look for respiratory distress risk factors. This is a descriptive, single-center study including 59, 55 and 72 children born at 34, 35 and 36 weeks gestation, respectively, in a level III center in 2005 and 2006 for babies born at 34 weeks and in 2006 for the babies born at 35 and 36 weeks. Of the mothers who delivered at 34 and 35 weeks, 63% and 49%, respectively, had a morbidity. The cesarean-section delivery rate before labor was 36% for the infants born at 34 weeks and 25% for the infants born at 35 weeks. Prenatal steroids were used for 57% of the mothers who delivered at 34 weeks and for 27% of the mothers who delivered at 35 weeks. In the population of the babies born at 34 weeks, a mean delay between the last dose of steroid and delivery was 18.9 days. Of the infants born at 34, 35 and 36 weeks, 27%, 18% and 8% suffered from respiratory distress. The mechanical ventilation rate was 8.5% and 5.5% for the infants born at 34 and 35 weeks' gestation. Surfactant was given to all infants born at 34 weeks who were intubated. Twenty percent of the 34-week-gestation infants and 12.7% of the 35-week-gestation infants required mechanical ventilation or noninvasive continuous positive airway pressure. Respiratory distress was mainly caused by respiratory distress syndrome or transient tachypnea of the newborn. There were no cases of meconium aspiration syndrome. There was 1 case of infection and 2 cases of pneumothorax. One-third of the infants born at 34-35 weeks were admitted to the neonatal intensive care unit. The number dropped to 11% at 36 weeks' gestation. The gestational age was the only significant risk factor for respiratory distress. There was a strong tendency of the respiratory distress rate to decrease in the babies whose mothers had received steroids (odds ratio = 0.39, p = 0.06).

Intravenous Valproate Use in Bipolar II Disorder After Gastric Bypass Surgery

Intravenous Valproate Use in Bipolar II Disorder After Gastric Bypass Surgery