Predictors of poor outcome in neonates with respiratory distress

Abstract

Background: To identify the determinants of mortality in neonates admitted in sncu of tertiary care hospital with respiratory distress. Neonatal intensive care unit in a tertiary level care hospital in central India. Study Design was a prospective observational study. Neonates admitted with respiratory distress over a period of 8 months. Methods: Neonates with respiratory distress i.e. respiratory rate >60/min, chest retraction, grunting, central cyanosis, were included in the study. Surgical problems causing respiratory distress i.e., congenital malformations affecting respiratory tract and congenital heart disease were excluded from the study. All the cases were divided in two groups based on outcome with good outcome defined as those babies who were discharged and poor outcome defined as those babies who expired during the treatment and analyzed. Results: On analysis, Antenatal history of per vaginal bleed, meconium stained liquor, prolonged rupture of membrane, VLBW, prematurity, pre-ductal SpO 2 , shock, apneic attacks, positive sepsis screen were found to be significantly associated with death. Conclusions: India in recent times has made huge improvement in neonatal care with establishing special care new born units. But, still the neonatal mortality rate is in higher range and needs further intense approach to reduce it. The antenatal and neonatal factors discussed above can be used as referral criteria for early referral of a new born with respiratory distress to a tertiary level new born unit for further management. The early identification and referral of a neonate with above risk factors may help in reducing the associated mortality and hence will reduce neonatal mortality.

Risk Factors of Respiratory Diseases Among Neonates in Neonatal Intensive Care Unit of Qena University Hospital, Egypt

“…Many variables had a great effect on the outcome of our studied cases as had an odds ratio >1 like male gender, RDS, CDH, pneumonia, apnea, tachypnea >60/min, cyanosis and irritability where apnea had the highest odd ratio of clinical signs. In the study of Panda et al apnea attack was recognized as a predictor of infant mortality and Sathenahalli et al described apnea as a sign of poor outcome in neonatal respiratory distress [36,37]. Furthermore we found that need for mechanical ventilation had the highest odd ratio.…”

Incidence of respiratory distress and its predictors among neonates admitted to the neonatal intensive care unit, Black Lion Specialized Hospital, Addis Ababa, Ethiopia

“…This incidence is even higher for infants born before 34 weeks' gestation [5] Certain risk factors increase the likelihood of neonatal RD. Recognized causes of RD in other low and high resource countries includes; prematurity, low first and fifth minute Apgar scores, meconium aspiration syndrome, caesarian section delivery, gestational diabetes, maternal chorioamnionitis, premature rupture of membranes [6], and oligohydramnios, as well as structural lung abnormalities are some predictors identified in previous studies [5,[7][8][9][10]. Other common causes include transient tachypnea of the newborn, meconium aspiration syndrome, pneumonia, sepsis, pneumothorax, and persistent pulmonary hypertension of the newborn [11].…”

The Relationship Between Serum Levels of Troponin I and Myocardial Function in Neonates Under Mechanical Ventilation

“…The high percentage of respiratory distress results in the use of a mechanical ventilation and hospitalization in the neonatal intensive care unit (5,6). The use of mechanical ventilation improves oxygenation and reduces CO 2 with accurate management of respiratory distress (4,20).…”

“…Perinatal period is associated with important cardio respiratory changes from intra uterine to extra uterine life (1). This process can be complicated by severe congenital (2,3) and systemic diseases (4)(5)(6)(7). In advanced stages of some systemic diseases such as asphyxia and sepsis, in neonatal period, cardiac dysfunction has been documented and in other patients exposed to hypoxia because of severe respiratory distress, degrees of myocardial damage has been observed (8)(9)(10)(11)(12)(13).…”