USE OF EARLY NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN PRETERM NEONATES WITH HYALINE MEMBRANE DISEASE

2021 ◽  
pp. 26-27
Author(s):  
Rakesh Kumar
Keyword(s):  
Severe Disease ◽  
Effective Means ◽  
Hyaline Membrane Disease ◽  
Assisted Ventilation ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Invasive Approach ◽  
Nasal Cpap ◽  
Antenatal Steroids ◽  
Hyaline Membrane

Background & Objective: Mechanical ventilation is the standard treatment for hyaline membrane disease (HMD) and has increased neonatal survival. However this increased survival has come at the expense of increased morbidity in the form of chronic lung disease, longer duration of hospitals stay and at the cost of expensive technology. Alternate form of respiratory support is early nasal CPAP. Hence present study aims at managing increasing number of preterm babies with HMD with a non-invasive approach in the form of early nasal CPAP. Methods: 50 babies of 28-34 weeks gestational age admitted in neonatal ICU of pediatrics Department at Patna Medical collage & hospital, Patna with clinical diagnosis of HMD, requiring respiratory support were treated with early nasal CPAP and studied prospectively from 01.12.2019 to 30.11.2020. Chi-square and other appropriate tests. We found a succ Statistical analysis: Results: ess rate of 80% in babies with HMD, who were managed with early nasal CPAP alone. Remaining 20% needed intubation and higher mode of ventilation. Mild and moderate grade HMD were effectively managed with early nasal CPAP (P<0.05). It was also found to be effective in babies of mothers who have received antenatal steroids (P<0.05). Prematurity is the commonest predi Conclusion: sposing cause for HMD. Early nasal CPAP is safe, inexpensive and effective means of respiratory support in HMD. it is useful in mild and moderate grade disease. It may not be a replacement for assisted ventilation in severe disease. It is also found to be effective in babies of mothers who have received antenatal steroids

USE OF EARLY NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN TREATMENT OF PRETERM NEONATES WITH HYALINE MEMBRANE DISEASE (NEONATAL RESPIRATORY DISTRESS SYNDROME)

2021 ◽  
pp. 15-17
Author(s):  
Ranjeet Kumar ◽  
Aarti Sharma ◽  
Falak Naaz ◽  
Zeeshan Ahmed
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Severe Disease ◽  
Effective Means ◽  
Neonatal Respiratory Distress Syndrome ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Antenatal Steroids ◽  
Neonatal Respiratory Distress

Objective:To evaluate the outcome of early nasal CPAPin premature neonates with neonatal respiratory distress syndrome. Methods: 100 babies of 28-34 weeks gestational age admitted in Neonatal ICU of Nalanda Medical College & Hospital, Patna (Bihar, India), with clinical diagnosis of HMD, requiring respiratory support were treated with early nasal CPAPand studied prospectively from 1st November 2014 to 31st October 2016. Results: We found a success rate of 80% in babies with HMD, who were managed with early nasal CPAPalone. Remaining 20% needed intubation and higher mode of ventilation. Mild and moderate grade HMD were effectively managed with early nasal CPAP (P<0.05). It was also found to be effective in babies of mothers who have received antenatal steroids (P<0.05). Conclusion: Prematurity is the commonest predisposing cause for HMD. Early nasal CPAPis safe, inexpensive and effective means of respiratory support in HMD. It is useful in mild and moderate grade disease. It may not be a replacement for assisted ventilation in severe disease. It is also found to be more effective in babies of mothers who have received antenatal steroids.

scholarly journals Use of early nasal continuous positive airway pressure in preterm neonates with hyaline membrane disease (neonatal respiratory distress syndrome)

2021 ◽  
Vol 8 (3) ◽  
pp. 488
Author(s):  
R. D. M. Suresh Reddy ◽  
Seshagiri Koripadu ◽  
Harischandra Venkata Yanamandala
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Respiratory Distress ◽  
Success Rate ◽  
Gestational Age ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Hyaline Membrane Disease ◽  
Nasal Cpap ◽  
Antenatal Steroids ◽  
Hyaline Membrane

Background: In developing countries like ours, there is high burden of prematurity and sub-optimal use of antenatal steroid administration resulting infrequent hyaline membrane disease (HMD).Methods: A total 50 cases of clinically diagnosed HMD with gestational age between 28-34 weeks admitted to neonatal intensive care unit (ICU). 50 babies were treated with early nasal continuous positive airway pressure (CPAP) (within 6 hours of onset of respiratory distress).Results: Incidence of prematurity was 12.42%. Incidence of HMD observed between gestational ages of 28-34 weeks is 3.2%. Out of total 50 babies who were managed with early nasal CPAP, it proved effective in 40 babies (80%), remaining 10 babies (20%) had to be intubated and required ventilation. Out of 10 babies who required ventilation 90% of the babies were less than 32 weeks gestation age; remaining 10% were between 33-34 weeks. Analysis of these results showed that outcome is better with increased gestational age (p<0.005). Out of 10 babies who failed 80% were <1500 g and remaining 20% above 1500 g. We found significant improvement (p<0.005) in SA score after application of nasal CPAP. Babies on CPAP had significant improvement in oxygenation (p<0.05). A success rate of 93.1% observed in moderate grade HMD (p<0.005). Out of 10 babies who failed on nasal CPAP, 80% of them had severe grade HMD and 20% showed moderate HMD. A success rate of 92.86% was found in babies of mothers who had received antenatal steroids and 63.63% of babies whose mothers had not received antenatal steroids improved with early nasal CPAP (p<0.05).Conclusions: Nasal CPAP is found to be effective in babies of mothers who had received antenatal steroids. Nasal CPAP is safe, inexpensive and effective means of respiratory support in HMD. Use of early nasal CPAP which is simple, non-invasive, has low capital outlay and does not require expertise, is the option for us where most places cannot provide invasive ventilation.

Association of Antenatal Terbutaline and Respiratory Support Requirements in Preterm Neonates

2021 ◽  
Author(s):  
Buranee Yangthara ◽  
Visanu Kittiarpornpon ◽  
Pitiporn Siripattanapipong ◽  
Walaiporn Bowornkitiwong ◽  
Ratchada Kitsommart ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Lung Compliance ◽  
Respiratory Support ◽  
Preterm Neonates ◽  
Non Invasive ◽  
Antenatal Steroids ◽  
Respiratory Outcomes ◽  
Record Review ◽  
Retrospective Medical Record Review

Background: Before the advent of antenatal steroids, early non-invasive respiratory support (NIV) and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS). Objectives: To study the association between antenatal terbutaline and endotracheal intubation (ET) within the first 24 hours of life, RDS, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) in infants with gestational age (GA) of < 32 weeks. And to study the association between antenatal terbutaline, and ET or NIV within the first 24 hours of life, and RDS in infants with GA of 32 to 36 weeks. Method: A retrospective medical record review of preterm infants delivered at a single tertiary care center from October 2016 to December 2020. Multivariable logistic regression was used to explore the association between antenatal terbutaline and neonatal respiratory support. Result: 1,794 infants were included, 234 (13.0%) had GA < 32 weeks and 1,560 (86.9%) had GA 32 to 36 weeks. Antenatal terbutaline, corticosteroid, or both agents were administered in 561 (31.3%), 1,461 (81.4%), and 555 (30.9%), respectively. Antenatal terbutaline was significantly associated with a reduction in ET (adjusted odds ratio (aOR) = 0.40, 95% confident interval (CI) 0.19 to 0.82, p = 0.012) in infants of GA < 32 weeks, but not in infants with GA 32 to 36 weeks. Antenatal terbutaline was not associated with RDS or BPD, but was significantly associated with a reduction in grade III-IV IVH (aOR 0.11, CI 0.01 to 0.98; p = 0.048), in infants of GA < 32 weeks. Conclusion: In a state-of-the-art neonatal care setting, antenatal terbutaline was associated with a reduction in ET during the first 24 hours in infants of GA < 32 weeks. The use of antenatal terbutaline to improve acute neonatal respiratory outcomes merits reconsideration.

Tension Pneumopericardium Following Assisted Ventilation in Hyaline Membrane Disease

Radiology ◽  
1973 ◽  
Vol 106 (1) ◽  
pp. 175-178 ◽  
Author(s):  
Stuart S. Sagel ◽  
Penington Wimbush ◽  
David B. Goldenberg
Keyword(s):  
Hyaline Membrane Disease ◽  
Assisted Ventilation ◽  
Hyaline Membrane ◽  
Tension Pneumopericardium

scholarly journals The burden of hyaline membrane disease, mortality and its determinant factors among preterm neonates admitted at Debre Tabor General Hospital, North Central Ethiopia: A retrospective follow up study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249365
Author(s):  
Binyam Minuye Birihane ◽  
Wubet Alebachew Bayih ◽  
Abebaw Yeshambel Alemu ◽  
Demeke Mesfin Belay ◽  
Asmamaw Demis
Keyword(s):  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Neonate ◽  
Hyaline Membrane Disease ◽  
Preterm Neonates ◽  
P Value ◽  
North Central ◽  
Disease Mortality ◽  
Hyaline Membrane

Background Hyaline membrane disease (HMD) is a leading cause of morbidity and mortality in preterm newborn babies. Though, there are studies related to Hyaline membrane disease inclusive of all neonates, studies related to the burden among preterm neonates were limited. In addition, increasing neonatal mortality in Ethiopia could be related to increase in the burden of hyaline membrane disease among preterm neonates. Therefore, this study was aimed to assess the burden of hyaline membrane disease, mortality and its associated factors among preterm neonate admitted at neonatal intensive care unit, North Central Ethiopia. Methodology An institution-based retrospective follow-up study was conducted among 535 preterm neonates admitted at neonatal intensive care unit from January 1, 2014-December 30, 2017. Data were entered into EPi-data 4.2.0.0 and transferred to STATA version 14 statistical software for statistical analysis. Binary logistic regression was used for the analysis. All variables with P-value < 0.25 during bi-variable analysis were considered for multivariable logistic regression. Level of statistical significance was declared at P value ≤0.05. Results In the current study, proportion of hyaline membrane disease was 40% (95% CI; 35.8, 44.3) of which 49.5% died. Preterm neonate born with Gestational age of less than 34 weeks of age (Adjusted odd ratio (AOR = 2.64; 95 CI: 1.49, 4.66)), 5th minute Apgar score less than 7 (AOR = 2.2; 95% CI: 1.20, 4.07), and newborn with birth weight of less than 1500 gram (AOR = 2.4, 95% CI: 1.3, 4.3) were predictors of hyaline membrane disease. Conclusions The mean gestational age (±) was 33.46 (±2.55) weeks. The incidence of hyaline membrane disease among preterm admissions was high. Preterm neonate born with gestational age of less than 34 weeks of age, asphyxiated newborns and newborn with birth weight of less than 1500 gram were predictors of hyaline membrane disease. So, emphasis should be given on early screening, follow up and timely interventions for preterm neonate.

scholarly journals Kangaroo mother care in Preterm baby receiving assisted respiratory support (CPAP): a case-control trial

2018 ◽  
Vol 5 (3) ◽  
pp. 1008 ◽  
Author(s):  
Pranav H. Punasanvala ◽  
Alpa N. Parekh ◽  
Jayendra R. Gohil ◽  
Sridhar Pujari
Keyword(s):  
Preterm Infants ◽  
Case Control ◽  
Assisted Ventilation ◽  
Kangaroo Mother Care ◽  
Respiratory Support ◽  
Secondary Outcome ◽  
Preterm Neonates ◽  
Early Weaning ◽  
Preterm Baby ◽  
College Hospital

Background: Kangaroo Mother Care (KMC) is conventionally initiated in a baby who is stable and may or may not be on intravenous fluids, enteral feeds or oxygen. We hypothesized that KMC will be beneficial to preterm babies receiving assisted respiratory support in the form of continuous positive airway pressure (CPAP).Methods: Prospective case-control trial of 28 preterm neonates (weight <2 kg and gestational age between 26 to 36 weeks) with respiratory distress who were on assisted respiratory support (CPAP), was conducted at a medical college hospital. They were studied in two groups of 14 each of KMC and no KMC. Primary outcome was early weaning from CPAP and secondary outcome was episodes of apnoea, hypothermia, septicaemia and mortality.Results: KMC group received KMC for an average 6.7 hours/ day. Most of the KMC practice occurred between 12 noon to midnight. Babies with KMC and NO KMC group took an average of (39±12) versus (52±24) hours to wean off from CPAP (p = ns). Episodes of apnoea, hypothermia, septicaemia and deaths were less in KMC group as compared to NO KMC group. Occurrence of physiological jaundice was higher among the KMC group as compared to the NO KMC group.Conclusions: It is possible to give KMC in preterm infants from the first day of birth who are on respiratory support (CPAP). Preterm infants receiving KMC had less episodes of apnoea, hypothermia, sepsis, and reduced mortality, though not significant. It was also beneficial in early weaning from assisted ventilation (CPAP).

scholarly journals Air Leak in Neonatal Respiratory Distress Syndrome

1984 ◽  
Vol 12 (1) ◽  
pp. 41-45 ◽  
Author(s):  
P. D. Sly ◽  
J. H. Drew
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Maternity Hospital ◽  
Assisted Ventilation ◽  
Air Leak ◽  
Mechanical Ventilators ◽  
Hyaline Membrane ◽  
Neonatal Respiratory Distress

A review of 9401 consecutive live births at the Mercy Maternity Hospital, Melbourne, was performed to determine the incidence of air leak in those with respiratory distress syndrome. Respiratory distress was detected in 552 (5.9%) infants and hyaline membrane disease was the most common cause occurring in 238 (2.5%) infants. Air leak developed in 22% of infants with respiratory distress, 8% had pulmonary interstitial emphysema alone, 14% had pneumomediastinum or pneumothorax and 7% had emphysema with pneumomediastinum or pneumothorax. Mortality increased from 12% in infants without air leak to 31% (p < 0.001) in infants with air leak. Ninety-five per cent of air leak developed in infants with hyaline membrane, and these were smaller, less mature and sicker than those without air leak. Eighty-seven per cent of air leak developed in infants treated with assisted ventilation and was commoner with mechanical ventilators with a more rapid rise in inspiratory pressure.

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