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Ristovska S. Respiratory Distress Syndrome (RDS) in Newborns with Hypoxic-Ischemic Encephalopathy (HIE). Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2024; 45:19-30. [PMID: 38575384 DOI: 10.2478/prilozi-2024-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Respiratory distress syndrome (RDS) and hypoxic-ischemic encephalopathy (HIE) are frequent causes of death and disability in neonates. This study included newborns between January 2021 and July 2022 at the University Clinic for Gynecology and Obstetrics, Skopje. Up to date criteria for HIE/RDS for term and for preterm infants as well for the severity of HIE/RDS were used in a comprehensive analysis of cranial ultrasonography, neurological status, neonatal infections, Apgar score, bradycardia and hypotension, X-ray of the lungs, FiO2, acid-base status, assisted ventilation and use of surfactant. Three groups were created: HIE with RDS (42 babies), HIE without RDS (30 babies) and RDS without HIE in 38 neonates. All newborns with severe (third) degree of HIE died. Intracranial bleeding was found in 35.7% in the first group and 30% in the second group, and in the third group in 53.3%. The need for surfactant in the HIE group with RDS is 59.5%, and in the RDS group without HIE 84.2%. DIC associated with sepsis was found in 13.1-50% in those groups. In newborns with HIE and bradycardia, the probability of having RDS was on average 3.2 times higher than in those without bradycardia. The application of the surfactant significantly improved the pH, pO2, pCO2, BE and chest X-ray in children with RDS. An Apgar score less than 6 at the fifth minute increases the risk of RDS by 3 times. The metabolic acidosis in the first 24 hours increases the risk of death by 23.6 times. The combination of HIE/ RDS significantly worsens the disease outcome. The use of scoring systems improved the early detection of high risk babies and initiation of early treatment increased the chances for survival without disabilities.
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Affiliation(s)
- Sanja Ristovska
- PJU University Clinic for Gynecology and Obstetrics, Faculty of Medicine, University of "St. Cyril and Methodius", Skopje, RN Macedonia
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Fang K, Yue S, Wang S, Wang M, Yu X, Ding Y, Lv M, Liu Y, Cao C, Liao Z. The association between sex and neonatal respiratory distress syndrome. BMC Pediatr 2024; 24:129. [PMID: 38373935 PMCID: PMC10875892 DOI: 10.1186/s12887-024-04596-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 01/26/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND To investigate the association between sex and neonatal respiratory distress syndrome (NRDS). METHODS Neonates born at our hospital and transferred to the neonatal department within 1 h were retrospectively analyzed. Depending on whether they developed NRDS during their hospital stay, the neonates was divided into NRDS and non-NRDS groups. There were 142 neonates in the NRDS group (95 males and 47 females) and 310 neonates in the non-NRDS group (180 males and 140 females). The neonates' data on gestational age (GA), sex, birth weight, white blood cell count (WBC), platelet count (PLT), C-reactive protein (CRP), total immunoglobulin M (total IgM), gestational diabetes mellitus(GDM), antenatal steroids use, meconium-stained amniotic fluid, and preterm premature rupture of membranes(PPROM) were gathered. RESULTS 452 neonates (265 males and 187 females) were involved for the purpose of collecting basic characteristic. Multivariate analysis, males had a 1.87 times higher risk of NRDS than females (P < 0.05) after controlling for the confounding effects of GA, birth weight, WBC, PLT, CRP, total IgM, GDM, antenatal steroids use, meconium-stained amniotic fluid, and PPROM. CONCLUSIONS Sex was associated with NRDS; males had a considerably higher risk of NRDS than females.
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Affiliation(s)
- Keren Fang
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Shaojie Yue
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Shuo Wang
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Mingjie Wang
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Xiaohe Yu
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Ying Ding
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Mei Lv
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Yang Liu
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China
| | - Chuanding Cao
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China.
| | - Zhengchang Liao
- Department of Neonatology, Xiangya Hospital, Central South University, Xiangya Road No.87, Changsha, Hunan Province, 410008, China.
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Pei J, Chen J. The influence of prenatal dexamethasone administration before scheduled full-term cesarean delivery on short-term adverse neonatal outcomes: a retrospective single-center cohort study. Front Pediatr 2024; 11:1323097. [PMID: 38274470 PMCID: PMC10808727 DOI: 10.3389/fped.2023.1323097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
Objective There has been a gradual increase in the prevalence of cesarean section deliveries and more healthcare professionals are considering the prophylactic use of corticosteroids before planned full-term cesarean sections. However, the association between dexamethasone administration before full-term cesarean delivery and short-term adverse neonatal outcomes is unclear. This study analyzed the disparities in short-term adverse neonatal effects in neonates born via full-term elective cesarean delivery with or without antenatal dexamethasone treatment. Study design This single-center retrospective cohort study involved neonates aged 37-39 weeks. The primary neonatal outcomes included various short-term adverse events, including neonatal admission to the neonatal intensive care unit, neonatal access to the special care baby unit, transient neonatal respiratory distress, respiratory distress syndrome, and the requirement of intravenous antibiotics or ventilatory support. Multiple logistic regression analysis was used to assess the association between these outcomes and dexamethasone exposure while adjusting for covariates. Results Of the 543 neonates included in the study, 121 (22.2%) had been exposed to prenatal dexamethasone. When compared with the control group, the dexamethasone-exposed group exhibited significantly higher rates of transient neonatal respiratory distress, respiratory distress syndrome, administration of intravenous antibiotics, the need for ventilatory support, and longer duration of neonatal hospitalization (P < 0.05). The association between dexamethasone exposure and short-term adverse neonatal outcomes remained significant after adjusting for potential confounders (odds ratio: 12.76, 95% confidence interval: 6.9-23.62, P < 0.001). Conclusion The dexamethasone-exposed group had a higher likelihood of experiencing short-term adverse outcomes when compared with non-exposed neonates, suggesting that dexamethasone may have detrimental effects on infants delivered at full term. This implies the importance of exercising caution when contemplating the use of antenatal corticosteroids.
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Affiliation(s)
| | - Jiao Chen
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chengdu Medical College, Xindu District, Chengdu, Sichuan Province, China
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Anciuc-Crauciuc M, Cucerea MC, Tripon F, Crauciuc GA, Bănescu CV. Descriptive and Functional Genomics in Neonatal Respiratory Distress Syndrome: From Lung Development to Targeted Therapies. Int J Mol Sci 2024; 25:649. [PMID: 38203821 PMCID: PMC10780183 DOI: 10.3390/ijms25010649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
In this up-to-date study, we first aimed to highlight the genetic and non-genetic factors associated with respiratory distress syndrome (RDS) while also focusing on the genomic aspect of this condition. Secondly, we discuss the treatment options and the progressing therapies based on RNAs or gene therapy. To fulfill this, our study commences with lung organogenesis, a highly orchestrated procedure guided by an intricate network of conserved signaling pathways that ultimately oversee the processes of patterning, growth, and differentiation. Then, our review focuses on the molecular mechanisms contributing to both normal and abnormal lung growth and development and underscores the connections between genetic and non-genetic factors linked to neonatal RDS, with a particular emphasis on the genomic aspects of this condition and their implications for treatment choices and the advancing therapeutic approaches centered around RNAs or gene therapy.
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Affiliation(s)
- Mădălina Anciuc-Crauciuc
- Genetics Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Târgu Mureș, Romania; (M.A.-C.); (C.V.B.)
- Neonatology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Târgu Mureș, Romania;
| | - Manuela Camelia Cucerea
- Neonatology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Târgu Mureș, Romania;
| | - Florin Tripon
- Genetics Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Târgu Mureș, Romania; (M.A.-C.); (C.V.B.)
| | - George-Andrei Crauciuc
- Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania;
| | - Claudia Violeta Bănescu
- Genetics Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Târgu Mureș, Romania; (M.A.-C.); (C.V.B.)
- Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu Mureș, Romania;
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Tochie JN, Sibetcheu AT, Arrey-Ebot PE, Choukem SP. Global, Regional and National Trends in the Burden of Neonatal Respiratory Failure and essentials of its diagnosis and management from 1992 to 2022: a scoping review. Eur J Pediatr 2024; 183:9-50. [PMID: 37847265 DOI: 10.1007/s00431-023-05238-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023]
Abstract
Neonatal respiratory failure (NRF) is an emergency which has not been examined extensively. We critically synthesized the contemporary in-hospital prevalence, mortality rate, predictors, aetiologies, diagnosis and management of NRF to better formulate measures to curb its burden. We searched MEDLINE and Google Scholar from 01/01/1992 to 31/12/2022 for relevant publications. We identified 237 papers from 58 high-income and low-and middle-income countries (LMICs). NRF prevalence ranged from 0.64 to 88.4% with some heterogeneity. The prevalence was highest in Africa, the Middle East and Asia. Globally as well as in Asia and the Americas, respiratory distress syndrome (RDS) was the leading aetiology of NRF. Neonatal sepsis was first aetiology in Africa, whereas in both Europe and the Middle East it was transient tachypnoea of the newborn. Independent predictors of NRF were prematurity, male gender, ethnicity, low/high birth weight, young/advanced maternal age, primiparity/multiparity, maternal smoking, pregestational/gestational diabetes mellitus, infectious anamneses, antepartum haemorrhage, gestational hypertensive disorders, multiple pregnancy, caesarean delivery, antenatal drugs, foetal distress, APGAR score, meconium-stained amniotic fluid and poor pregnancy follow-up. The NRF-related in-hospital mortality rate was 0.21-57.3%, highest in Africa, Asia and the Middle East. This death toll was primarily due to RDS globally and in all regions. Clinical evaluation using the Silverman-Anderson score was widely used and reliable. Initial resuscitation followed by specific management was the common clinical practice. CONCLUSION NRF has a high burden globally, driven by RDS, especially in LIMCs where more aggressive treatment and innovations, preferably subsidized, are warranted to curb its alarming burden. WHAT IS KNOWN • Neonatal respiratory failure is a frequent emergency associated with a significant morbidity and mortality, yet there is no comprehensive research paper summarizing its global burden. • Neonatal respiratory failure needs prompt diagnosis and treatment geared at improving neonatal survival. WHAT IS NEW • Neonatal respiratory failure has an alarmingly high global burden largely attributed to Respiratory distress syndrome. Low resource settings are disproportionately affected by the burden of neonatal respiratory failure. • Independent preditors of neonatal respiratory failure are several but can be classified into foetal, maternal and obstetrical factors. An illustrative pedagogical algorithm is provided to facilitate diagnosis and management of neonatal respiratory failure by healthcare providers.
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Affiliation(s)
- Joel Noutakdie Tochie
- Anaesthesiology and Intensive Care Unit, Douala Laquintinie Hospital, Douala, Cameroon.
| | - Aurelie T Sibetcheu
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Simeon-Pierre Choukem
- Department of Internal Medicine and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
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Caffarelli C, Santamaria F, Piro E, Basilicata S, Delle Cave V, Cipullo M, Bernasconi S, Corsello G. New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine. Ital J Pediatr 2022; 48:189. [PMID: 36435791 PMCID: PMC9701393 DOI: 10.1186/s13052-022-01374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022] Open
Abstract
In this review, we report the developments across pediatric subspecialties that have been published in the Italian Journal of Pediatrics in 2021. We highlight advances in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, hematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine.
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Affiliation(s)
- Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Ettore Piro
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Simona Basilicata
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Valeria Delle Cave
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Marilena Cipullo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | | | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
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Wang Y, Wang M, Zhang H, Wang Y, Du Y, Guo Z, Ma L, Zhou Y, Zhang H, Liu L. Sivelestat improves clinical outcomes and decreases ventilator-associated lung injury in children with acute respiratory distress syndrome: a retrospective cohort study. Transl Pediatr 2022; 11:1671-1681. [PMID: 36345446 PMCID: PMC9636449 DOI: 10.21037/tp-22-441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Sivelestat, a neutrophil elastase inhibitor, is a selective and targeted therapy for acute respiratory distress syndrome (ARDS) in adults; and it is also reported to apply to children with ARDS. However, there is little evidence of its efficacy in children. METHODS This study recruited 212 patients ranging in age from 28 days to 18 years old, and who met the diagnostic criteria for pediatric ARDS (PARDS) while hospitalized in the Intensive Care Department of the Affiliated Children's Hospital of Xi'an Jiaotong University. A total of 125 patients (case group) received sivelestat treatment, and 87 were assigned to the control group. There were no significant differences in gender (P=0.445) or age (P=0.521). Control group data were collected from the Electronic Case Information System for pediatric patients diagnosed with ARDS between March 2017 to January 2020. Data for the case group were collected from the Electronic Case Information System between February 2020 to February 2022. Demographic data, clinically relevant indicators, respiratory parameters were recorded. The 28-day mortality was the primary endpoint; the Kaplan-Meier and log-rank tests were used to evaluate cumulative survival rate. RESULTS For general demographic and clinical characteristics, no significant differences were observed between the two groups. Compared to the control group, the case group displayed significant improvements in PaO2/FiO2 at 48 h (141±45 vs. 115±21, P<0.001) and 72 h (169±61 vs. 139±40, P<0.001) post-admission, and plateau pressure was lower than that in the control group at 24 h (24±3 vs. 28±7, P<0.001), 48 h (21±4 vs. 26±7, P<0.001), and 72 h (20±2 vs. 25±6, P<0.001) post-admission. Interleukin-8 levels were lower in the case group at 48 and 72 h post-admission. Overall, 28-day mortality was 25.47% (54/212). Twenty-five children died in the sivelestat group, 29 children died in the control group. Survival analysis revealed that cumulative survival in the case group was higher than that in the control group (P=0.028). CONCLUSIONS ARDS is expected to have high morbidity and mortality in critical care medicine, and precise targeted drugs are lacking. Our study showed that sivelestat improved prognosis and reduces mortality in children with ARDS.
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Affiliation(s)
- Yi Wang
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Wang
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hua Zhang
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Wang
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanqiang Du
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhangyan Guo
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Le Ma
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yong Zhou
- Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huiping Zhang
- Neonatal Intensive Care Unit, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Li Liu
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Ibrahimou B, Sun N, Burchfield S, Shrestha P, Veitzman F, Bursac Z, Salihu H, Dagne G, Gasana J, Guilarte TR. Race as a moderator of the association between ethnicity, preeclampsia and neonatal respiratory distress syndrome. World J Pediatr 2022; 18:568-573. [PMID: 35650375 PMCID: PMC10574812 DOI: 10.1007/s12519-022-00571-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Boubakari Ibrahimou
- Department of Biostatistics, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA.
| | - Ning Sun
- Department of Biostatistics, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA
| | - Shelbie Burchfield
- Department of Biostatistics, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA
| | - Priyanka Shrestha
- Department of Biostatistics, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA
| | - Fernanda Veitzman
- Department of Biostatistics, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA
| | - Hamisu Salihu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, One Baylor Plaza MS: 411, Houston, TX, 77030, USA
| | - Getachew Dagne
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL, 33612, USA
| | - Janvier Gasana
- Faculty of Public Health, Department of Environmental and Occupational Health, Kuwait University, Block 7 Street 32013119, PO Box 24923, Safat, Hawally, Kuwait
| | - Tomas R Guilarte
- Department of Environmental Health Sciences, Florida International University, Robert Stempel College of Public Health and Social Work, 11200 S.W. 8th Street, AHC5, Miami, FL, 33199, USA
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Liu H, Feng H, Zhang Y, Zhang L. Efficacy and safety of nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure ventilation in neonatal respiratory distress syndrome: a systematic review and meta-analysis. Transl Pediatr 2022; 11:1242-1250. [PMID: 35957996 PMCID: PMC9360829 DOI: 10.21037/tp-22-288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/14/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The efficacies of nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) in neonatal respiratory distress syndrome (RDS) are controversial. The reasons for controversy may be the selection bias of research objects and the small sample size. METHODS Literature retrieval was performed in PubMed, EMBASE, Medline, Central, China National Knowledge Infrastructure (CNKI), Wanfang and China Science Digital Library (CSDL) databases. Inclusion criteria: (I) literatures involving subjects who were newborns with RDS; (II) studies that had established both experimental and control groups; (III) the intervention measures of the experimental and control groups were NIPPV and NCPAP, respectively; (IV) the results included the incidence of intubation, bronchopulmonary dysplasia (BPD), or mortality; and (V) randomized controlled trials (RCTs). The chi-square test was applied for heterogeneity test. Publication bias assessment was conducted by funnel plot and Egger's test. The revised Cochrane risk of bias tool for individually randomized, parallel group trials (RoB2.0) was used to evaluate the risk of bias of the included RCT research. RESULTS A total of 10 literatures were included for analysis, including 1,104 patients, 557 in the NIPPV group and 547 in the NCPAP group. Among the literatures, 2 literatures had low risk of bias, 2 literatures had high risk of bias, and the rest had uncertain risk of bias. Compared to NCPAP, NIPPV reduced the incidence of neonatal intubation in RDS [risk ratio (RR) =0.57, 95% confidence interval (CI): 0.46-0.71, Z=5.11, P<0.00001]. There was no statistically significant heterogeneity (P=0.13, I2=36%) or publication bias (P<0.05) among the studies. Compared with NCPAP, NIPPV reduced the incidence of BPD in RDS (RR =0.72, 95% CI: 0.57-0.91, Z=2.70, P=0.007). There was no statistically significant heterogeneity (P=0.10, I2=41%) or publication bias (P>0.05) among the studies. NIPPV reduced the neonatal mortality rate of RDS (RR =0.55, 95% CI: 0.31-0.97, Z=2.08, P=0.04). There was no statistically significant heterogeneity (P=0.20, I2=38%) or publication bias (P>0.05) among the studies. DISCUSSION Compared with NCPAP, NIPPV can reduce the incidence of intubation, BPD, and mortality. The conclusions need to be confirmed via high-quality RCTs.
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Affiliation(s)
- Hua Liu
- Neonatal Department, Haikou Maternal and Child Health Hospital, Haikou, China
| | - Haiping Feng
- Neonatal Department, Sanya Central Hospital (Hainan Third People's Hospital), Sanya, China
| | - Yao Zhang
- Neonatal Department, Haikou Maternal and Child Health Hospital, Haikou, China
| | - Li Zhang
- Neonatal Department, Haikou Maternal and Child Health Hospital, Haikou, China
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Wang JJ, Zhang L, Cai N. A comparative study of the efficacy and safety of high-flow nasal cannula and nasal continuous positive airway pressure in neonatal respiratory distress syndrome: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29109. [PMID: 35475798 PMCID: PMC9276122 DOI: 10.1097/md.0000000000029109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND When it comes to preterm newborns, respiratory distress syndrome (RDS) is the most frequent respiratory condition. Despite the fact that it is well acknowledged that preterm delivery plays a significant role, the causes of lung damage are still not completely understood. In newborns with extremely low birth weight and neonatal RDS, nasal continuous positive airway pressure has been suggested as the first respiratory assistance for spontaneous breathing. In the current research, we aim to carry out a meta-analysis to assess the effectiveness and safety of high-flow nasal cannula (HFNC) and non-invasive continuous positive airway pressure (nCPAP) in patients with neonatal respiratory distress syndrome (NRDS). METHODS We intend to search the following databases: PubMed, EMBASE, Cochrane Library, Wanfang database, China National Knowledge Infrastructure (CNKI), and Google Scholar, starting from their initial publication until February 2022, to identify randomized controlled trials comparing HFNC to nCPAP in patients with NRDS. The suitable papers will be chosen by 2 writers who will work independently of one another. Using the Cochrane updated technique for risk of bias, each included article will be subjected to an independent data extraction process by the 2 writers who will then independently evaluate the risk of bias. Consequently, a third author will be asked to address any discrepancies that may arise between the writers. It will be necessary to pool the data and do a meta-analysis with the help of the RevMan 5.3 software. RESULTS In this study, the effectiveness and safety of HFNC will be compared with those of nCPAP in patients with NRDS. CONCLUSION If the results of this research are confirmed, they may serve as a summary of the most recent data for non-invasive respiratory assistance in NRDS. ETHICS AND DISSEMINATION The study will require ethical approval. REGISTRATION NUMBER DOI 10.17605/OSF.IO/BKSQ5.
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Shi S, Guo J, Fu M, Liao L, Tu J, Xiong J, Liao Q, Chen W, Chen K, Liao Y. Evaluation of the neonatal sequential organ failure assessment and mortality risk in neonates with respiratory distress syndrome: A retrospective cohort study. Front Pediatr 2022; 10:911444. [PMID: 35935348 PMCID: PMC9352873 DOI: 10.3389/fped.2022.911444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Respiratory distress syndrome (RDS) is one of the leading causes of neonatal death in the neonatal intensive care unit (NICU). Previous studies have suggested that the development of neonatal RDS may be associated with inflammation and lead to organ dysfunction. The neonatal sequential organ failure assessment (nSOFA) scoring system is an operational definition of organ dysfunction, but whether it can be used to predict mortality in neonates RDS is unknown. The aim of this study was to clarify the performance of the nSOFA score in predicting mortality in patients with neonatal RDS, with the aim of broadening the clinical application of the nSOFA score. METHODS Neonates with RDS were identified from the Medical Information Mart for Intensive Care (MIMIC)-III database. Cox proportional hazards model were used to assess the association between nSOFA score and mortality. Propensity score matched analysis were used to assess the robustness of the analytical results. RESULTS In this study of 1,281 patients with RDS of which 57.2% were male, death occurred in 40 cases (3.1%). Patients with high nSOFA scores had a higher mortality rate of 10.7% compared with low nSOFA scores at 0.3%. After adjusting for confounding, multivariate Cox proportional risk analysis showed that an increase in nSOFA score was significantly associated with increased mortality in patients with RDS [adjusted Hazards Ratio (aHR): 1.48, 95% Confidence Interval (CI): 1.32-1.67; p < 0.001]. Similarly, the High nSOFA group was significantly associated with higher mortality in RDS patients (aHR: 19.35, 95% CI: 4.41-84.95; p < 0.001) compared with the low nSOFA group. CONCLUSION The nSOFA score was positively associated with the risk of mortality in cases of neonatal RDS in the NICU, where its use may help clinicians to quickly and accurately identify high risk neonates and implement more aggressive intervention.
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Affiliation(s)
- Shanshan Shi
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.,The Third Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Jie Guo
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Minqiang Fu
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Lihua Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.,The Third Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Jiabin Tu
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.,The Third Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Jialing Xiong
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.,The Third Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Quanwang Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Weihua Chen
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.,The Third Clinical Medicine College, Fujian Medical University, Fuzhou, China
| | - Kaihong Chen
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Ying Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
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