Prognosis of Very Preterm Infants with Severe Respiratory Distress Syndrome Receiving Mechanical Ventilation

Sun, Haiyan; Yan, Zhou; Xiong, Hong; Kang, Wengqing; Xu, Bangli; Liu, Dapeng; Zhang, Xiaoli; Li, Huixia; Zhou, Chunmei; Zhang, Yinghui; Zhou, Mingjin; Meng, Qingping

doi:10.1007/s00408-014-9683-5

Cited by 15 publications

(13 citation statements)

References 22 publications

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“…Neonatal RDS refers to a condition with respiratory failure and progressive respiratory distress shortly after the birth of an infant due to the lack of pulmonary surfactant and end-expiratory alveolar collapse, and in which an initial symptom is respiratory acidosis. In case of deterioration, the condition develops into metabolic acidosis, greatly affecting the life quality and survival rate of the newborn ( 5 , 6 ). The main clinical manifestations include cyanosis, polypnea, respiratory moaning inspiratory three depressions sign, and air bronchogram and ground-glass changes on chest X-rays.…”

Section: Discussionmentioning

confidence: 99%

Correlation of expression levels of caspase-3 and Bcl-2 in alveolar lavage fluid in neonatal respiratory distress syndrome and prognosis

Lin

Wang

2018

Exp Ther Med

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This study was designed to investigate the correlation between expression levels of cysteine aspartic protease-3 (caspase-3) and B-cell lymphoma gene-2 (Bcl-2) proteins in alveolar lavage fluid and the prognosis of infants with neonatal respiratory distress syndrome (RDS). A total of 150 infants with neonatal RDS undergoing alveolar lavages were divided into four groups: RDS1 (group A, n=42), RDS2 (group B, n=38), RDS3 (group C, n=38) and RDS4 (group D, n=32) according to their thoracic X-ray film grading. The oxygen uptake score, oxygenation saturation, mean airway pressure and expression levels of caspase-3 and Bcl-2 in alveolar lavage fluid of the infants in the four groups were measured and compared. Our results showed higher grading by thoracic X-rays in patients with increased oxygen uptake score, oxygenation index, mean airway pressure, caspase-3 expression level, hospital stay, complications and death rates in all groups; however, the expression levels of Bcl-2 were decreased in those cases, and the differences had statistical significance among the four groups (P<0.05). Analyses for correlation showed a caspase-3 positive area that was positively correlated with oxygen uptake score, oxygenation index and mean airway pressure (P<0.05); and a Bcl-2 expression level that was negatively correlated with oxygen uptake score, oxygenation index and mean airway pressure (P<0.05). Based on our findings, the severity of neonatal RDS is positively correlated with the concentration of caspase-3 in alveolar lavage fluid, and negatively correlated with the expression level of Bcl-2.

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Section: Discussionmentioning

confidence: 99%

Correlation of expression levels of caspase-3 and Bcl-2 in alveolar lavage fluid in neonatal respiratory distress syndrome and prognosis

Lin

Wang

2018

Exp Ther Med

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“…Several studies support that RDS is a risk factor for the development of IVH [25, 36, 37, 120, 121]. RDS is associated with the fluctuation of cerebral blood flow [122–124], low blood pressure [125], use of mechanical ventilation and hypoxia-ischemia [126], all of which increase the risk of IVH.…”

Section: Discussionmentioning

confidence: 99%

The combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome increases the risk of intraventricular hemorrhage in preterm neonates

Park

Hong

et al. 2017

Journal of Perinatal Medicine

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OBJECTIVE To evaluate the impact of combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome (RDS) on the development of intraventricular hemorrhage (IVH) in preterm neonates. METHODS This retrospective cohort study includes 207 consecutive preterm births (24.0–33.0 weeks of gestation). Intra-amniotic inflammation was defined as an amniotic fluid matrix metalloproteinase-8 concentration >23 ng/mL. According to McMenamin’s classification, IVH was defined as grade II or higher when detected by neurosonography within the first weeks of life. RESULTS 1) IVH was diagnosed in 6.8% (14/207) of neonates in the study population; 2) IVH was frequent among newborns exposed to intra-amniotic inflammation when followed by postnatal RDS (33% [6/18]). The frequency of IVH was 7% (8/115) among neonates exposed either to these conditions—intra-amniotic inflammation or RDS—and 0% (0/64) among those who were not exposed to these conditions; and 3) neonates exposed to intra-amniotic inflammation and postnatal RDS had a significantly higher risk of IVH than those with only intra-amniotic inflammation [odds ratio (OR), 4.6; 95% confidence interval (CI), 1.1–19.3) and those with RDS alone (OR, 5.6; 95% CI, 1.0–30.9), after adjusting for gestational age. CONCLUSION The combined exposure to intra-amniotic inflammation and postnatal RDS markedly increased the risk of IVH in preterm neonates.

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“…No studies reported prevalence of any (aggregate of any severity) NDI at ≥5 years follow-up; prevalence of moderate-severe NDI was 10%. 84 The prevalence of any CP was 6% between 12 and 18 months follow-up, 67 7%–17% at 18 months to 2 years follow-up, 68,69,74 6%–33% between 2 and 5 years follow-up, 79,81 and 0% at ≥5 years follow-up. 84…”

Section: Resultsmentioning

confidence: 97%

“…Twenty studies from outside North America and Europe reported findings for NDI (Table 3). 12,[67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85] Sample size ranged from eight (infants with focal intestinal perforation) to 2883. 73,83 Most (17/20) studies were retrospective.…”

Section: Ndi By Geographic Locationmentioning

confidence: 99%

Global prevalence of long-term neurodevelopmental impairment following extremely preterm birth: a systematic literature review

Sarda

Sarri²,

Siffel

2021

J Int Med Res

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Objective Neurodevelopmental impairment (NDI) is a major complication of extreme prematurity. This systematic review was conducted to summarize the worldwide long-term prevalence of NDI associated with extreme prematurity. Methods Embase and MEDLINE databases were searched for epidemiologic and observational/real-world studies, published in English between 2011 and 2016, reporting long-term prevalence of NDI (occurring from 1 year) among extremely preterm infants born at gestational age (GA) ≤28 weeks. Results Of 2406 articles identified through searches, 69 met the protocol NDI definition (24 North America, 25 Europe, 20 Rest of World). Prevalence of any severity NDI in North America was 8%–59% at 18 months to 2 years, and 11%–37% at 2–5 years; prevalence of moderate NDI in Europe was 10%–13% at 18 months to 2 years, 3% at 2–5 years, and 9%–19% at ≥5 years; prevalence of any NDI in Rest of World was 15%–61% at 18 months to 2 years, and 42% at 2–5 years (no North America/Rest of World studies reported any NDI at ≥5 years). A trend toward higher prevalence of NDI with lower GA at birth was observed. Conclusions Extreme prematurity has a significant long-term worldwide impact on neurodevelopmental outcomes.

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Prognosis of Very Preterm Infants with Severe Respiratory Distress Syndrome Receiving Mechanical Ventilation

Abstract: The prognosis of very preterm infants with severe RDS may be influenced by several prenatal and postnatal factors. HFOV although decreased the duration of mechanical ventilation, whether it will decrease the incidence of neurodevelopmental disability, needs to be explored further.

Cited by 15 publications

References 22 publications

Correlation of expression levels of caspase-3 and Bcl-2 in alveolar lavage fluid in neonatal respiratory distress syndrome and prognosis

Correlation of expression levels of caspase-3 and Bcl-2 in alveolar lavage fluid in neonatal respiratory distress syndrome and prognosis

The combined exposure to intra-amniotic inflammation and neonatal respiratory distress syndrome increases the risk of intraventricular hemorrhage in preterm neonates

Global prevalence of long-term neurodevelopmental impairment following extremely preterm birth: a systematic literature review

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