Acute Neonatal Respiratory Failure

Bohn, Desmond; Dargaville, Peter A.; Davis, Peter G; Hutchison, Alastair A.; Owen, Louise

doi:10.1007/978-3-642-01219-8_47

Cited by 5 publications

(6 citation statements)

References 569 publications

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“…Apnea, along with cyanosis, inspiratory stridor, snorting, nasal flaring, grunting, feeding difficulties, and tachypnea are crucial clinical signs indicative of respiratory distress in neonates. 17,18 Intercostal and subcostal retractions are also very frequent clinical presentations that further signify respiratory distress in neonates. 19 Primary conditions like respiratory distress syndrome, transient tachypnea of the neonate (TTN), and meconium aspiration syndrome (MAS) are among the most prevalent causes of respiratory distress and these conditions further result in compromised lung function, leading to breathing difficulties and respiratory distress in neonates.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of respiratory distress and outcome in neonates admitted in National Institute of Child Health, Karachi, Pakistan.

Lachhman Singh Rajput,

Mashal Khan

2024

TPMJ

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Objective: To find out the spectrum of respiratory distress and outcome in neonates admitted to Neonatal Intensive care unit (NICU) of National Institute of Child Health (NICH), Karachi, Pakistan. Study Design: Cross-sectional study. Setting: NICU of NICH, Karachi, Pakistan. Period: June 2022 to May 2023. Methods: We analyzed 148 neonates of either gender presenting with respiratory distress. At the time of enrollment, demographic and clinical information was noted in all neonates along with detailed maternal history. Relevant laboratory and radiological studies were performed. Final outcomes were recorded in terms of discharged, expired or referred. Results: In a total of 148 neonates, 96 (64.9%) were boys. The mean age was 4.04±5.65 days. Tachypnea, nasal flaring, intercostal recession, subcostal recession, grunting, and cyanosis 148 (100%), 146 (98.6%), 138 (93.2%), 133 (89.9%), 97 (65.5%), and 83 (56.1%) were the most frequent clinical presentations among neonates with respiratory distress. The most frequent causes behind respiratory distress were noted to be respiratory distress syndrome, sepsis, and meconium staining of labour in 31 (20.9%), 25 (16.9%), and 24 (16.2%) neonates. Mortality was observed in 21 (14.2%) neonates. Significant association of neonates presenting with congenital pneumonia (p=0.048), or congenital anomalies (p<0.001) were found to with poor outcomes. Mechanical ventilation was found to have significant relationship with poor outcomes (p<0.001). Conclusion: Tachypnea, Nasal flaring, intercostal and subcostal recessions, grunting, and cyanosis were the primary clinical presentations among the neonates with respiratory distress. Congenital pneumonia, and congenital anomalies emerged as key predictors of poor outcomes.

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Section: Discussionmentioning

confidence: 99%

Spectrum of respiratory distress and outcome in neonates admitted in National Institute of Child Health, Karachi, Pakistan.

Lachhman Singh Rajput,

Mashal Khan

2024

TPMJ

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“…A low Apgar score at birth, cardiac defects, intestinal blockage, the use of inotropes, and reduced respiratory function are some factors. The clinical events that can reduce the diffusion in the intestine or even the saturation of O 2 in the blood are associated with NEC [41]. It has been observed that septicemia is associated with a higher incidence of the occurrence of NEC.…”

Section: Predisposing Factors For Necmentioning

confidence: 99%

Gut Microbiota and Immune System in Necrotizing Enterocolitis and Related Sepsis

Jirillo,

Topi,

Charitos

et al. 2024

Gastrointestinal Disorders

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A severe condition of sepsis can be a complication of necrotizing enterocolitis (NEC), which can occur in premature infants and becomes a medical challenge in the neonatal intensive care unit (NICU). It is a multifactorial intestinal disease (can affect both the small and large intestine) that can lead to ischemia of the intestinal tissues that evolves into acute organ necrosis. One of these factors is that different types of nutrition can influence the onset or the progression of the disease. Cow-milk-based infant formulas have been shown to cause it in premature infants more frequently than human milk. Recently, nutrition has been shown to be beneficial after surgery. Several issues still under study, such as the pathogenesis and the insufficient and often difficult therapeutic approach, as well as the lack of a common and effective prevention strategy, make this disease an enigma in daily clinical practice. Recent studies outlined the emerging role of the host immune system and resident gut microbiota, showing their close connection in NEC pathophysiology. In its initial stages, broad-spectrum antibiotics, bowel rest, and breastfeeding are currently used, as well as probiotics to help the development of the intestinal microbiota and its eubiosis. This paper aims to present the current knowledge and potential fields of research in NEC pathophysiology and therapeutic assessment.

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“…In fact, oxygenation depends on several factors, such as peripheral perfusion, cardiac output, oxygen concentration in arterial blood, fetal hemoglobin level, temperature, degree of lung maturity and development, pressure used on the CPAP and the gas leakage through the open mouth, etc. [14,15]. Respiratory support allows to control only a part of these indicators.…”

Section: Factorsmentioning

confidence: 99%

Risk factors of preterm infants with CPAP intubated for mechanical ventilation

Borysiuk¹,

Matsyura²,

Беш³

et al. 2023

Ukr.Biochem.J.

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Early use of continuous positive airway pressure (CPAP) is equal to the prophylactic administration of a surfactant to prevent neonatal respiratory distress syndrome (nRDS) in high-risk infants. However, almost half of the smallest infants still require intubation and mechanical ventilation in the first 72 hours after birth. It is known that ineffective initial CPAP is associated with a poorer prognosis. Therefore, the search for reliable prognostic risk factors for ineffective CPAP in very preterm neonates whose respiratory support is started with CPAP is still relevant today. The results of a retrospective cohort study conducted at the Lviv Regional Clinical Hospital (Ukraine), which included 151 children with birth weight <1500 g and gestational age <32 weeks, showed that CPAP failure occurred at a median age of five hours in 31% of infants initially treated with CPAP and average (SD) FiO2, while the failure point was 0.48 (0.15). The prevalence of the main risk factors for severe nRDS did not differ significantly between two groups (CPAP success and CPAP failure). The risk of CPAP failure was significantly associated with surfactant treatment (OR – 7.46; 95% CI: 2.3–24.2), severe RDS (OR – 12.17; 95% CI: 3.8–39.3), requirement in resuscitation after birth (OR – 3.10; 95% CI: 1.2–8.1), initial CPAP pressure (OR – 0.38; 95% CI: 0.15–0.99). Earlier administration of exogenous surfactant to children at high risk of developing severe RDS could prevent the need for mechanical ventilation. Keywords: CPAP failure, neonatal respiratory distress syndrome mechanical ventilation, preterm infants, surfactant

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Acute Neonatal Respiratory Failure

Cited by 5 publications

References 569 publications

Spectrum of respiratory distress and outcome in neonates admitted in National Institute of Child Health, Karachi, Pakistan.

Spectrum of respiratory distress and outcome in neonates admitted in National Institute of Child Health, Karachi, Pakistan.

Gut Microbiota and Immune System in Necrotizing Enterocolitis and Related Sepsis

Risk factors of preterm infants with CPAP intubated for mechanical ventilation

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