A new clinical respiratory distress score for surfactant therapy in preterm infants with respiratory distress

Nanda, Debasish; Nangia, Sushma; Thukral, Anu; Yadav, Chander Prakash

doi:10.1007/s00431-019-03530-5

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…The good accuracy of SF ratio found in the study is not surprising since FiO 2 is the main factor for surfactant administration and a good predictor of CPAP failure. 25 , and yet may be very useful in other settings as reported by Nanda et al 27 Despite very few studies have evaluated the diaphragmatic function in VPI on noninvasive ventilation, the diaphragmatic measurements found in our study are consistent with the previous publications. [28][29][30] We also found a significant positive correlation between diaphragmatic thickness and anthropometric data as reported, 31 Optimizing antenatal care, avoiding intubation in delivery room, caffeine and early surfactant with a less invasive technique when needed, are proven strategies or "bundles" to reduce BPD.…”

Section: Discussionsupporting

confidence: 91%

“…Clinical and perinatal variables did not predict accurately the need for surfactant treatment in our study. The high rate of antenatal steroids, the assessment of Silverman score in VPI on CPAP and having excluded patients intubated in delivery room may have influenced these results, and yet may be very useful in other settings as reported by Nanda et al 27 …”

Section: Discussionmentioning

confidence: 98%

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Lung ultrasound for early surfactant treatment: Development and validation of a predictive model

Aldecoa‐Bilbao¹,

Balcells-Esponera

Barbero³

et al. 2020

Pediatric Pulmonology

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Aim: To develop and validate a feasible predictive model for early surfactant treatment in very preterm infants (VPI) admitted with respiratory distress syndrome (RDS). Methods: Preterm infants less than 32 weeks of gestation with RDS and stabilized with noninvasive ventilation in delivery room were recruited (January 2018-April 2020). Clinical data, chest X-ray (CXR) score, respiratory support, oxygen saturation/fraction of inspired oxygen ratio (SF ratio), lung ultrasound (LUS) score, and diaphragmatic thickening fraction (DTF) were recorded at 60-120 min of life. Oxygen threshold for surfactant administration was fraction of inspired oxygen more than 30%; ultrasound findings were blinded. Logistic regression models using a stepwise selection of variables were developed in the derivation cohort. Coefficients from these models were applied to the validation cohort and a diagnostic performance was calculated. Results: A total of 144 VPI with a mean gestational age of 28.7 ± 2.2 weeks were included (94 into the derivation cohort, 50 into the validation cohort); 37 required surfactant treatment (25.7%). Gestational age, SF ratio, LUS score, CXR score, and Silverman score were related to surfactant administration (R 2 = .823). Predictors included in the final model for surfactant administration were SF ratio and LUS score (R 2 = .783) with an area under the receiver operating characteristic (AUC) = 0.97 (95% confidence interval [CI]: 0.93-1.00) in the derivation cohort and an AUC = 0.95 (95% CI: 0.85-0.99) in the validation cohort. By applying our predictive model, 26 patients (70.2%) would have been treated with surfactant earlier than 2 h of life. Conclusion: The predictive model showed a high diagnostic performance and could be of value to optimize early respiratory management in VPI with RDS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Lung ultrasound for early surfactant treatment: Development and validation of a predictive model

Aldecoa‐Bilbao¹,

Balcells-Esponera

Barbero³

et al. 2020

Pediatric Pulmonology

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“…Though such scores have been developed, surfactant availability and training of health care personnel might be bottle necks. 12 For the other secondary outcomes of air leak and receipt of repeated doses of surfactant, NMA indicated that earlier surfactant administration at FiO 2 of 22–30%, aAO 2 < 0.36 and that guided by lamellar body counts might possibly be beneficial.…”

Section: Discussionmentioning

confidence: 99%

“…Other parameters for predicting the severity of RDS that have been studied include arterial alveolar oxygen tension ratio (a/AO 2 ), lamellar body counts in lung- or gastric aspirates, lung ultrasound and clinical scoring systems of respiratory distress. 8 , 10 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Clinical decision thresholds for surfactant administration in preterm infants: a systematic review and network meta-analysis

Ramaswamy¹,

Bandyopadhyay²,

Abiramalatha³

et al. 2023

eClinicalMedicine

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“…В работе 2020 г. с включением 153 новорожденных 27-35 недель ГВ с респираторной поддержкой методом СРАР обнаружено, что ГВ менее 32 нед., отсутствие антенатальной кортикостероидной профилактики, гипотермия при поступлении, оценка по шкале Апгар менее 3 баллов на 1 мин. и оценка по шкале Сильвермана более 2 баллов в возрасте 2 ч. жизни являются значимыми факторами в прогнозировании потребности сурфактантной терапии [23].…”

Section: интерпретация результатовunclassified

Comparison of the Assessment of Respiratory Disorders Using the Downes and Silverman Scales in the Delivery Room in Newborns Over 35 Weeks of Gestation with CPAP Respiratory Therapy as a Predictor of Transfer to the Intensive Care Unit. Cohort Study

Fedotova,

Shestak,

Kovtun

2024

Урал. мед. журнал

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Rationale. Respiratory distress (RD) aﬅer birth is the leading cause of neonatal intensive care unit (NICU) admission. To determine the degree of RD, scales based primarily on clinical symptoms have been developed, but the prognostic value of RD scales remains incompletely studied.Purpose of the study — to determine and compare the prognostic value of the Downes and Silverman RD scoresin the delivery room in neonates ≥35 0 weeks of gestation with CPAP therapy as a predictor of NICU admission.Materials and methods. The study included newborns ≥35 0 weeks of gestation with RDin the delivery room. The study was conducted at the Ekaterinburg Clinical Perinatal Center from March 1 to August 15, 2023. The predicted outcome was hospitalization from the delivery room to the NICU. In the general sample (n = 73), subgroups were identiﬁed according to the studied predictor at the start of CPAP therapy: subgroup D1 — Downes scale score n = 24); subgroup D2 — Downes scale score ≥4 points (n = 49); subgroup S1 — Silverman scale score n = 31); subgroup S2 — Silverman score ≥4 points (n = 42).Results. In subgroup D2, the relative risk of NICU admission was 3.9with a 95 % conﬁdenceinterval (CI) of 1.3–11.7, sensitivity of 88.9 % and speciﬁcity of 45.7 %; in subgroup S2–2.1with 95 % CI 1.021–4.300, sensitivity 74.1 % and speciﬁcity 52.2 %.Conclusion. Assessment of RD in newborns ≥35 0 weeks of gestation in the delivery room on the Downes scale ≥4 points at the start of CPAP therapy allows predicting the ineﬀectiveness of respiratory therapy and transfer of the child to the NICU. The accuracy of the forecast when assessed using the Downes scale is higher than that using the Silverman scale.

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A new clinical respiratory distress score for surfactant therapy in preterm infants with respiratory distress

Cited by 5 publications

References 18 publications

Lung ultrasound for early surfactant treatment: Development and validation of a predictive model

Lung ultrasound for early surfactant treatment: Development and validation of a predictive model

Clinical decision thresholds for surfactant administration in preterm infants: a systematic review and network meta-analysis

Comparison of the Assessment of Respiratory Disorders Using the Downes and Silverman Scales in the Delivery Room in Newborns Over 35 Weeks of Gestation with CPAP Respiratory Therapy as a Predictor of Transfer to the Intensive Care Unit. Cohort Study

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