Downes Score vs Silverman Anderson Score for Assessment of Respiratory Distress in Preterm Newborns

Shashidhar, A; Pn, Suman Rao; Jose, Joe

doi:10.7199/ped.oncall.2016.30

Cited by 12 publications

(12 citation statements)

References 3 publications

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“…The validity of Downes' score was shown to be 88% sensitivity (95% CI, 79-99) and 81% specificity (95% CI, 70-91) to identify respiratory distress. 19 The reliability is shown by high interrater reliability (α = .69). 19…”

Section: Methodsmentioning

confidence: 98%

Standardized nCPAP Care Bundle to Decrease Days to Wean Off nCPAP

Kim-Yang

Huffman

2021

Advances in Neonatal Care

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Background: Effective bubble nasal continuous positive airway pressure (bnCPAP) implementation is a means to maintain functional residual capacity (FRC) and avoid pulmonary morbidities in neonates. Purpose: A quality improvement project was introduced to establish a standardized bnCPAP care bundle. Methods: A bnCPAP care bundle focusing on shoulder roll use, bnCPAP positioning, assessment for suctioning need, and nasopharynx suctioning was created. The outcome measures collected were percentage of time the infant's pulse saturation was less than 86%, corrected gestational age (CGA) when off bnCPAP, length of time a neonate is on bnCPAP, Downes' score, and compliance to bnCPAP care bundle. Results: An independent-samples t test found a statistically significant higher mean prior to the initiative in the percentage of time the oxygen saturation was less than 86%, Downes' score, length of time, and CGA to wean off bnCPAP (M = 11.7% ± 10.1%, M = 1.6 ± 1.1, M = 27.7 days ± 29.0 days, and M = 35.0 weeks ± 3.38 weeks, respectively) than after the initiative (M = 4.0% ± 4.8%, M = 1.1 ± 0.8, M = 11.2 days ± 10.2 days, and M = 32.8 weeks ± 1.00 weeks, respectively). Implications for Practice and Research: Implementing a standardized bnCPAP care bundle showed improvement in oxygen saturation and increased success of weaning off bnCPAP. Future studies to increase the collected data are needed to compare the outcomes on infants born at each gestational age.

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Section: Methodsmentioning

confidence: 98%

Standardized nCPAP Care Bundle to Decrease Days to Wean Off nCPAP

Kim-Yang

Huffman

2021

Advances in Neonatal Care

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“…Serial evaluation of the infant's respiratory, cardiovascular, and neurological status helps detect any serious changes that require immediate intervention, thus minimising bNCPAP failure and complications [ 43 , 71 ]. The Clinical Respiratory Distress Scoring System (Downes score) and Silverman-Andersen Respiratory Severity Score are the two commonly used tools for grading the severity of respiratory distress and for monitoring clinical improvement [ 31 , 72 – 74 ]. The Downes score ( Table 3 ) reliably correlates with arterial blood gases (ABGs) and is thus a very useful adjunct in settings where ABGs are not available [ 75 ].…”

Section: Care Of Infants On Ncpapmentioning

confidence: 99%

Bubble Nasal Continuous Positive Airway Pressure (bNCPAP): An Effective Low-Cost Intervention for Resource-Constrained Settings

Egesa

Waibi

2020

International Journal of Pediatrics

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Preterm birth complications are responsible for almost one-third of the global neonatal mortality burden, and respiratory distress syndrome remains the single most common cause of these preventable deaths. Since its inception, almost half a century ago, nasal continuous positive airway pressure (NCPAP) has evolved to become the primary modality for neonatal respiratory care in both the developed and developing world. Although evidence has demonstrated the effectiveness of low-cost bubble NCPAP in reducing newborn mortality, its widespread use is yet to be seen in resource-constrained settings. Moreover, many tertiary hospitals in developing countries still utilise an inexpensive locally assembled bNCPAP system of unknown efficacy and safety. This review provides a brief overview of the history, physiological benefits, indications, contraindications, and complications of bNCPAP. Evidence regarding the effectiveness of low-cost bNCPAP in the neonatal intensive care unit is also summarised. The article further details a locally assembled bNCPAP system used in resource-constrained settings and highlights the care package for neonates receiving bNCPAP, failure criteria, and strategies for weaning.

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“…As the underlying pathology is dynamic, the clinician has to monitor these neonates closely and adjust the pressures or oxygen (FiO2) provided to these babies. Important bedside monitoring parameters are the severity of respiratory distress on clinical examination, which is subjective and SpO2 [2]. Invasive blood gas analysis and estimation of alveolar-arterial oxygen difference (A-aDO2) are done on an intermittent basis to assess the progress of the disease and make necessary clinical decisions [3].…”

Section: Introductionmentioning

confidence: 99%

“…Many of the practices in the neonatal intensive care are unit specific and hence lack uniformity across the globe [2,4]. One such practice is initial respiratory support [5,6].…”

Section: Introductionmentioning

confidence: 99%

Saturation oxygenation pressure index: a non-invasive bedside measure for severity of respiratory disease in neonates on CPAP

et al. 2020

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The treatment of respiratory distress in neonates ranges from non-invasive continuous positive airway pressure (CPAP) to advanced invasive mechanical ventilation. Monitoring on CPAP is often done by calculating oxygenation after blood gas analysis which is an invasive procedure. Saturation oxygen pressure index (SOPI) is a simple, non-invasive, bedside tool to monitor the severity of respiratory illness in neonates on CPAP. This study was aimed at validation of SOP index against AaDO2 and determine the cutoff values of SOPI for A-aDO2 of 70, 85 and100. This was a prospective observational study on 126 neonates with respiratory distress and treated with CPAP. The correlation between SOPI and A-aDO2 was validated using Bootstrap method. There was a significant positive correlation between SOPI and A-aDO2 with the Spearman correlation coefficient (rho) being 0.815 (p = 0). The mean coefficient of correlation after Bootstrap was 0.827 (p value < 0.0001). SOPI values of 1.52, 1.57 and 1.6 predicted A-aDO2 value of 70, 85 and 100 with a sensitivity of above 80% and specificity above 90%, respectively. Conclusion: SOPI has a significant positive correlation of 82.7% against A-aDO2 and can be a valuable tool to assess respiratory distress in neonates without arterial blood gas. Keywords SOP index. Non-invasive assessment. Respiratory distress. Neonates Abbreviations N-CPAP Nasal continuous positive airway pressure OI Oxygenation index SOPI Saturation oxygen pressure index AaDO2 Alveolar arterial oxygen difference CDP Continuous distending pressure FiO 2 Fraction of inspired oxygen NICU Neonatal intensive care unit SpO 2 Arterial oxygen saturation H 2 O Water PEEP Positive end-expiratory pressure ROC Receiver operative characteristics IQR Interquartile range SD Standard deviation What is Known: • Saturation oxygen pressure index (SOPI) is a non-invasive monitoring tool for neonates on N-CPAP. • SOPI has a good correlation with AaDO2. What is New: • Correlation of SOPI with AaDO2 is now validated. • Values between 1.52 and 1.88 indicate clinically useful range of AaDO2 for escalation of respiratory support from CPAP.

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Downes Score vs Silverman Anderson Score for Assessment of Respiratory Distress in Preterm Newborns

Cited by 12 publications

References 3 publications

Standardized nCPAP Care Bundle to Decrease Days to Wean Off nCPAP

Standardized nCPAP Care Bundle to Decrease Days to Wean Off nCPAP

Bubble Nasal Continuous Positive Airway Pressure (bNCPAP): An Effective Low-Cost Intervention for Resource-Constrained Settings

Saturation oxygenation pressure index: a non-invasive bedside measure for severity of respiratory disease in neonates on CPAP

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