Transient Tachypnea of the Newborn: Pathogenesis, Diagnosis, Treatment

Shestak, Evgenii V.; Ковтун, О. П.

doi:10.15690/vsp.v21i1.2381

Cited by 2 publications

(3 citation statements)

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“…Ural Medical Journal umjusmu.ru В свою очередь, российские клинические рекомендации 1 , а также приказ Минздрава России № 203н 2017 г. 2 рекомендуют использование оценки ДН у доношенных с помощью шкалы Доунса, а у недоношенных новорожденных -шкалы Сильвермана. В настоящее время отсутствуют четкие критерии неэффективности проводимой респираторной терапии методом СРАР (постоянное положительное давление в дыхательных путях -от англ.…”

Section: Original Articleunclassified

“…Становление адекватного самостоятельного дыхания после рождения является ключевым процессом адаптации ребенка к внеутробной жизни. Этому способствует ряд механизмов, происходящих в кардиореспираторной системе: созревание альвеол и сосудов системы легких, выработка достаточного количество сурфактанта, своевременная реабсорбция фетальной жидкости [1,2]. Однако существуют факторы, отрицательно влияющие на послеродовую респираторную адаптацию ребенка.…”

Section: Introductionunclassified

“…Симптомы ДН у ребенка с различными патологиями неспецифичны и проявляются: тахипноэ с частотой дыхания (ЧД) более 60 в мин. ; стонущим дыханием; раздуванием крыльев носа; дрожанием подбородка; втяжением надключичных и подключичных ямок, яремной вырезки, межреберий, грудины и гаррисоновой борозды; асинхронным участием в акте дыхания грудной клетки и живота; гипоксемией с развитием цианоза, а также патологической аускультативной картиной в легких [2,6]. На основании этих данных клиницистами разработаны шкалы оценки ДН, такие как модифицированная шкала Доунса (англ.…”

Section: Introductionunclassified

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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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Section: Original Articleunclassified

Section: Introductionunclassified

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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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Standardized approach to CPAP therapy in the delivery room in full-term infants with congenital infection: observational research

Shestak,

Kovtun

2023

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Background. At the present day, there are no protocols and guidelines on the therapeutic approaches of respiratory disorders in full-term infants in the delivery room. This concerns indications for the choice of respiratory therapy, parameters and its duration for deciding on effectiveness.The aim of the study is — to evaluate the effectiveness and safety of the standardized CPAP (continuous positive airway pressure) protocol therapy of transient tachypnea of newborns (TTN) in the delivery room in full-term infants with congenital infection.Methods. An observational clinical study of the efficacy and safety of the standardized CPAP therapy protocol developed by us for children with TTN in the delivery room in children with congenital infection, used during 6 months of 2021 in comparison with the historical control group recruited according to the same criteria for 12 months of 2020. The assessment of cerebral damage, the nature and duration of respiratory therapy and the duration of hospitalization of patients in comparison with those in the historical control group was carried out.Results. In 2020, out of 3901 full-term infants, CPAP was performed in the delivery room for 223 children, 31 of them with infection (control group). In 2021, out of 2057 full-term CPAP was performed on 140 children, 15 of them with infection (study group). A comparative analysis of the groups revealed no statistical differences in anthropometric data, gestational age, gender, APGAR score, as well as differences in the history of pregnancy and childbirth. The analysis of clinical characteristics also showed no differences between the groups (control group versus study group) in the frequency of cerebral ischemia (25 (80.6%) of the control group versus 9 (60.0%) of the study group; p = 0.135) and subependymal hemorrhage (6 (19.3%) of the control group versus 3 (20.0%) of the study group; p = 0.959), the frequency of ventilation (10 (32.2%) of the control group versus 5 (33.3%) of the study group; p = 0.942) and its duration (1 (1; 1.75) of the control group versus 2 (1.25; 2) days of the study group; p = 0.211), the frequency of BinCPAP (9 (29.3%) of the control group versus 5 (33.3%) of the study group; p = 0.434) and its duration (1 (1; 2) of the control group versus 1 (1; 1) day of the study group; p = 0.434) and the total duration of hospitalization (14 (10; 16) control groups versus 12 (12; 14) days of the study group; p = 0.429).Conclusion. The conducted study does not exclude that the standardized protocol of CPAP therapy in the delivery room for congenital infection is ineffective and does not affect the severity and duration of the disease, however, in combination with the data of the same protocol for TTN described in our previous studies, the high frequency of TTN and the low frequency of infection, the impossibility of their early differentiation allows assume, that the presented method can be considered as a universal respiratory strategy for full-term newborns with respiratory insufficiency in the delivery room.

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Transient Tachypnea of the Newborn: Pathogenesis, Diagnosis, Treatment

Cited by 2 publications

References 92 publications

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

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

Standardized approach to CPAP therapy in the delivery room in full-term infants with congenital infection: observational research

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