Comparison of chest radiography and static respiratory compliance in the assessment of the severity of pulmonary diseases in newborns with respiratory distress

Abstract

In 55 newborn infants with respiratory distress syndrome (RDS) we compared chest radiographs and static respiratory compliance to see which of the two methods would best characterize the severity of pulmonary disease. There was a significant correlation between radiological score and compliance (rs = -0.5776, n = 55, p less than 0.001). Healthy newborns, newborns with RDS who did not need artificial ventilation and those newborns who needed respirator treatment had significantly different values of radiological score and compliance. RDS may be differentiated into groups of diagnoses. Newborns with HMD could be separated from those with wet lung syndrome or aspiration pneumonia by analyzing the radiogram or measuring the compliance. When survivors are compared with those newborns who died, the static respiratory compliance alone could predict the final outcome.

Respiratory mechanics in ventilated preterm infants: early determinants and outcome

“…Both incidence rate and RDS severity are still inversely proportional to gestational age and birth weight (Table 1). 163 41%/26% 1997 163 42%/29% 1989-1999 163 40-45% nationally 1993 54 30% 20% 14% 0% 7% nationally 200 154 24%/8% 17%/6% 10%/4% 0% 2% <1000 g 1000-1500 g >1500 54 19%/9% 7%/2% 0% 2% a 'Classic' BPD, as described by Northway and colleagues. 197 b CLD defined as supplemental oxygen requirement for 28 days after birth.…”

“…152,164 In contrast to our findings, Lischka and colleagues described significant associations between their score and Crs within 24 hours after birth. 154 Others described correlations between Giedion scores and parameters of lung function 43,124 , However, these studies were performed before exogenous surfactant therapy had been widely introduced. Many infants in our study did receive exogenous surfactant at the first day of life, which is known to affect both radiological and functional aspects, decreasing RDS severity 32 and increasing Crs directly.…”

“…Ventilator setting was adjusted to keep the arterial Digital chest radiographs were obtained at maximal inspiratory level in supine position. Five radiological scores for preterm neonates were used: Lischka, 154 Yuksel, 277 Greenough, 95 Toce 242 and Giedion 86 (Table 1). Two paediatric pulmonologists (B.A.…”

“…Yuksel et al, 277 Greenough et al 95 and Toce et al 242 developed scores to predict the respiratory outcome of preterm infants. Scores of Lischka et al 154 and Giedion et al 86 were developed to indicate the severity of respiratory distress syndrome (RDS). The scores are mainly based on characteristics like lung volume, air bronchograms, reticulogranular pattern, and the presence of cysts that may point to RDS (Figure 1) or a beginning chronic lung disease of the newborn (CLD; Figure 2).…”

“…169,203 Such associations have been studied only scarcely in ventilated preterm infants. 154 In order to evaluate the clinical value of chest radiographs in preterm ventilated infants, we studied the interobserver agreement of radiological scoring systems and whether these scoring systems related to functional markers of the respiratory condition at that time.…”