Respiratory severity score and extubation readiness in very low birth weight infants

Mhanna, Maroun J.; Iyer, Narayan P.; Piraino, Scott W.; Jain, Mohit

doi:10.1016/j.pedneo.2016.12.006

Cited by 29 publications

(30 citation statements)

References 28 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One study reported that the RSS on day 30 of life can provide useful prognostic information for very low birth weight infants undergoing prolonged mechanical ventilation 9) . Recently, a study addressing RSS and extubation readiness in very low birth weight infants was published 27) . These reports, along with ours, suggest that the RSS can be used as a reliable respiratory predictive factor.…”

Section: Resultsmentioning

confidence: 99%

Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

Ahn¹,

Jung²,

Shin³

et al. 2018

Neonatal Med

View full text Add to dashboard Cite

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without inva sive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lungtohead ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal mem brane oxygenation (ECMO), and survival, was collected. The highest respiratory se verity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial dia gnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P= 0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cutoff value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

show abstract

Section: Resultsmentioning

confidence: 99%

Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

Ahn¹,

Jung²,

Shin³

et al. 2018

Neonatal Med

View full text Add to dashboard Cite

show abstract

“… FiO 2 , fraction of inspired oxygen; MAP, mean airway pressure; P/F ratio, PaO 2 /FiO 2 ; PaCO 2 , arterial partial pressure of carbon dioxide; PaO 2 , arterial partial pressure of oxygen; RS‐Score, respiratory severity score [FiO 2 × MAP]; SpO 2 , pulse oxymetric oxygen saturation. …”

Section: Resultsmentioning

confidence: 99%

“… FiO 2 , fraction of inspired oxygen; MAP, mean airway pressure; msec, millisecond; P/F ratio, PaO 2 /FiO 2 ; PH, pulmonary hypertonus; SpO 2 , pulse oxymetric oxygen saturation; TPV, time to peak velocity; RS‐Score, respiratory severity score [FiO 2 × MAP]; RVET, right ventricular ejection time. …”

Section: Resultsmentioning

confidence: 99%

“…Therefore, we compared the RS‐Score, which differed significantly between both groups. The RS‐Score is easy to obtain and has been demonstrated to be associated with an extubation failure . Although, the RS‐Score seems to be associated with extubation failure in CDH infants as well, it should be investigated in a larger cohort whether a modified score, including factors like severity of PH, cardiac dysfunction, or pleural effusions, might be superior to predict the risk of extubation failure in this population.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and echocardiographic risk factors for extubation failure in infants with congenital diaphragmatic hernia

Schroeder

Reutter

Gembruch

et al. 2018

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…RSS has been shown to closely correlate with OI across a wide range of oxygen saturations in premature, ventilated infants 22,24 . In VLBW infants, the score has been used on the day of extubation to assess potential reintubation risk 25 . RSS has also been employed as a measure of illness severity in several large scale multicentered, randomized clinical trials to ensure patients of similar acuity are randomized equally upon enrollment between control and intervention groups.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Severity Score greater than or equal to 2 at birth is associated with an increased risk of mortality in infants with birth weights less than or equal to 1250 g

Shah

Aboudi

Gamma

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

Objective Respiratory Severity Score (RSS), the product of mean airway pressure and the fraction of inspired oxygen may estimate the severity of neonatal lung disease. We aimed to determine if RSS on the first day of life is associated with mortality and/or comorbidities in infants born less than or equal to 1250 g. Methods Data were extracted from the NYS Perinatal Data System for premature inborn infants from 2006 to 2016 born between 400 and 1250 g (N = 730). RSS was divided into three categories: less than 2 (low, n = 310), 2–5 (moderate, n = 265), greater than 5 (high, n = 155). The primary outcome was mortality. Logistic regression determined associations with composite outcomes of death or respiratory morbidity (respiratory support after 36 weeks postmenstrual age), death or neurologic morbidity (periventricular leukomalacia) or high‐grade intraventricular hemorrhage), and death/severe morbidity (death or neurologic morbidity or respiratory morbidity or stage ≥ III retinopathy of prematurity or necrotizing enterocolitis) by RSS category. Results Birthweight and gestational age were lower with the increasing RSS category (p < .001 for both). Mode of delivery, antenatal steroids, and maternal age did not differ by RSS. In adjusted analyses, there were increased odds of mortality in infants with moderate RSS (odds ratio [95% confidence intervals]: 3.1 (1.7–5.4) and high 4.5 (2.5–8.2). These groups had higher odds of death or respiratory morbidity, death or neurologic morbidity, and death/severe morbidity. Conclusion Higher RSS (≥2) is associated with an increased risk of mortality and morbidities in infants born less than or equal to 1250 g.

show abstract

Respiratory severity score and extubation readiness in very low birth weight infants

Abstract: An elevated RSS is associated with extubation failure. Successful unplanned extubation is common in VLBW infants.

Cited by 29 publications

References 28 publications

Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

Clinical and echocardiographic risk factors for extubation failure in infants with congenital diaphragmatic hernia

Respiratory Severity Score greater than or equal to 2 at birth is associated with an increased risk of mortality in infants with birth weights less than or equal to 1250 g

Contact Info

Product

Resources

About