705 results on '"Transient tachypnea of the newborn"'
Search Results
2. the Inhaled β2-adrenergic Receptor Agonist for Transient Tachypnoea of the Newborn (the REFSAL Trial) (REFSAL)
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University of Ottawa, Jagiellonian University, Pomeranian Medical University Szczecin, Poznan University of Medical Sciences, Jan Biziel University Hospital No 2 in Bydgoszcz, Neonatology Unit, Specialist Hospital No 2, Bytom, University of Rzeszow, and University in Zielona Góra
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- 2024
3. Pulmonary Function Using Non-invasive Forced Oscillometry (PUFFOR)
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Colm Travers, Principal Investigator
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- 2024
4. Physiologically Based Cord Clamping To Improve Neonatal Outcomes After Elective Cesarean Delivery (PhyCord1)
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The Belgian Kids Fund, Fonds IRIS-Recherche, and Ars Statistica
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- 2024
5. Reducing Respiratory Distress After Elective Caesarean Birth Through Knee-chest-flexion: a Randomized Controlled Trial
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Leiden University Medical Center
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- 2024
6. Assessment of Diastolic Function During the Transitional Period and Infancy Using Serial Echocardiography (DiFuSE)
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Dr. Gene Dempsey, Horgan Chair in Neonatology, Consultant Neonatologist
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- 2024
7. Safety and Efficacy of 2.5 mg and 1.25 mg Nebulized Salbutamol Compared with Placebo on Transient Tachypnea of the Newborns: A Triple-Blind Phase II/III Parallel Randomized Controlled Trial.
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Choobdar, Farhad Abolhasan, Vahedi, Zahra, Mazouri, Ali, Torkaman, Mohammad, Khosravi, Nastaran, Khalesi, Nasrin, Soltani, Zahra, Mohazzab, Arash, and Ashkanipour, Rezvan
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MECONIUM aspiration syndrome , *NEONATAL intensive care units , *ALBUTEROL , *PULMONARY hypertension , *BLOOD pressure - Abstract
Background: To evaluate the safety and efficacy of 2.5 and 1.25 mg nebulized salbutamol on Transient Tachypnea of the Newborn (TTN) compared with placebo. Methods: We conducted a triple-blind, phase II/III parallel randomized controlled trial in two university-affiliated hospitals with neonatal intensive care units. Newborns with a confirmed diagnosis of TTN, with gestational age >35 weeks and gestational weight >2 kg were included. Cases of asphyxia, meconium aspiration syndrome, and persistent pulmonary hypertension were excluded. Ninety eligible patients were randomly allocated in three intervention groups (2.5 mg salbutamol, 1.25 mg salbutamol, and placebo), and a single-dose nebulized product was prescribed 6 hours after the birth. Safety outcomes included postintervention tachycardia, hyperglycemia, hypokalemia, and changes in blood pressure. To evaluate the efficacy, the duration of postintervention tachypnea, TTN clinical score, and clinical and paraclinical respiratory indices were assessed. Parents, Outcome assessors, and data analyzer were blind to the intervention. Results: There was no adverse reaction, including tachycardia, hypokalemia, and jitteriness. Both groups of salbutamol recipients showed significant improvement regarding respiratory rate, TTN clinical score, and oxygenation indices compared with the placebo (p-values <0.001). Nonstatistically significant higher hospital stay was observed in the placebo group. Single 2.5 mg salbutamol nebulization showed a little better outcome than the dose of 1.25 mg, although we could not find statistical superiority. Conclusion: The newly applied single high dose of 2.5 mg nebulized salbutamol is safe in treating TTN and leads to notable faster improvement of respiratory status without any considerable adverse reaction. Registry code: IRCT20190328043133N1. [ABSTRACT FROM AUTHOR]
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- 2024
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8. nHFOV Versus nCPAP in Transient Tachypnea of the Newborn
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Mehmet Cizmeci, Associate Professor of Pediatrics
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- 2023
9. Neonatal Intensive Care
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Gokulakrishnan, Ganga, Tillman, Davlyn, Liao, Nancy, editor, Mahan, John, editor, Misra, Sanghamitra, editor, Scherzer, Rebecca, editor, and Schiller, Jocelyn, editor
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- 2024
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10. Thoracic fluid content (TFC) using electrical cardiometry versus lung ultrasound in the diagnosis of transient tachypnea of newborn.
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EL-Fattah, Nagwa Mohamed Abd, EL-Mahdy, Heba Saied, Hamisa, Manal Fathy, and Ibrahim, Ashraf Mohamed
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LUNGS , *NEWBORN infants , *TACHYPNEA , *ULTRASONIC imaging , *OXYGEN therapy - Abstract
This study aimed to evaluate TFC by EC versus lung ultrasound (LUS) findings for diagnosing and follow-up of TTN in late preterm and term neonates. This prospective observational study was conducted on 80 neonates with gestational age ≥ 34 weeks. TTN group included 40 neonates diagnosed with TTN, and no lung disease (NLD) group included 40 neonates without respiratory distress. LUS and EC were performed within the first 24 h of life and repeated after 72 h. There was a statistically significant increase in TFC in TTN group on D1 [48.48 ± 4.86 (1 KOhm−1)] compared to NLD group [32.95 ± 4.59 (1 KOhm−1)], and then significant decrease in TFC in D3 [34.90 ± 4.42 (1 KOhm−1)] compared to D1 in the TTN group. There was a significant positive correlation between both TFC and LUS with Downes' score, TTN score, and duration of oxygen therapy in the TTN group. Conclusion: Both LUS and TFC by EC provide good bedside tools that could help to diagnose and monitor TTN. TFC showed a good correlation with LUS score and degree of respiratory distress. What is Known: • Transient tachypnea of the newborn (TTN) is the most common cause of respiratory distress in newborns. • TTN is a diagnosis of exclusion, there are no specific clinical parameters or biomarker has been identified for TTN. What is New: • Thoracic fluid content (TFC) by electrical cardiometry is a new parameter to evaluate lung fluid volume and could help to diagnose and monitor TTN and correlates with lung ultrasound score. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Risk of Transient Tachypnea of the Newborn following Elective Cesarean Section Increases at a Gestational Age of 37 Weeks Compared to That at = 38 Weeks Despite the Exclusion of Pre-Existing Risk Factors for Neonatal Respiratory Disorders.
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Yoichi Mino, Fumiko Miyahara, Mazumi Miura, Aya Imamoto, Hiromi Fujii, Chisaki Moriwaki, Kazuki Yoshioka, and Noriyuki Namba
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TACHYPNEA ,CESAREAN section ,RESPIRATORY disease risk factors ,GESTATIONAL age ,BIRTH weight - Abstract
Background: Elective cesarean sections (ECSs) for early-term pregnancies at 37 weeks of gestational age (GA) aim to reduce the risk of emergency cesarean sections due to the onset of labor or rupture of membranes. However, resultant increases in neonatal respiratory disorders, including transient tachypnea of the newborn (TTN) have been observed. However, few studies have elucidated the associated risk factors. Consequently, we aimed to determine whether differences existed in the clinical outcomes between neonates delivered via ECS at 37 weeks and those delivered at ≥ 38 weeks of GA. Methods: A retrospective analysis was conducted on 259 neonates born via ECS at Tottori University Hospital, between January 2013 and December 2019, with birthweights ≥ 2500 g and GAs > 37 weeks. The neonates were categorized into two cohorts: births at 37 and at ≥ 38 weeks of GA (37-week and 38-week cohorts). The principal clinical outcomes included the appearance, pulse, grimace, activity, and respiration (Apgar) scores, need for positive-pressure ventilation, incidence of TTN, and length of hospital stay. Results: No statistically significant differences were observed in the indications for ECS, sex, or birthweight between the two cohorts. The 37-week cohort exhibited a lower 1-min Apgar score than did the 38-week cohort, with no statistically significant differences between the two cohorts, at 5 min. Statistically significant differences were not observed in the need for positivepressure ventilation during initial resuscitation or length of hospital stay for patients with TTN between the two cohorts. Notably, the 37-week cohort exhibited a significantly higher incidence of TTN than did the 38-week cohort. Conclusion: ECSs at 37 weeks of GA exhibited an increased risk of TTN than ECSs at = 38 weeks of GA. Strategic neonatal care and adequate preparation can mitigate this risk without affecting the length of hospital stay. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Neonatal point-of-care lung ultrasound: what should be known and done out of the NICU?
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Alonso-Ojembarrena, Almudena, Gregorio-Hernández, Rebeca, and Raimondi, Francesco
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MECONIUM aspiration syndrome , *NEONATAL intensive care units , *RESPIRATORY distress syndrome , *ULTRASONIC imaging , *NEONATAL intensive care - Abstract
Lung ultrasound is rapidly becoming a useful tool in the care of neonates: its ease of use, reproducibility, low cost, and negligible side effects make it a very suitable tool for the respiratory care of all neonates. This technique has been extensively studied by different approaches in neonatal intensive care unit (NICU), both for diagnostic and prognostic aims and to guide respiratory treatments. However, many neonates are being born in level I/II hospitals without NICU facilities so all pediatricians, not just neonatal intensivists, should be aware of its potential. This is made possible by the increasing access to ultrasound machines in a modern hospital setting. In this review, we describe the ultrasonographic characteristics of the normal neonatal lung. We also discuss the ultrasound features of main neonatal respiratory diseases: transient tachypnea of the neonate (TTN), respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), pneumothorax (PNX), pleural effusion (PE), or pneumonia. Finally, we mention two functional approaches to lung ultrasound: The use of lung ultrasound in level I delivery centers as a mean to assess the severity of neonatal respiratory distress and request a transport to a higher degree structure in a timely fashion. The prognostic accuracy of lung ultrasound for early and targeted surfactant replacement. Conclusion: LU is still a useful tool in level I/II neonatal units, both for diagnostic and functional issues. What is Known: • Neonatal lung ultrasound has been recently introduced in the usual care in many Neonatal Intensive Care Units. What is New: • It also has many advantages in level I/II neonatal units, both for neonatologist or even pediatricians that treat neonates in those sites. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Burden and Outcomes of Respiratory Diseases in Hospitalized Neonates at a Tertiary Care Hospital in Lahore: A Cross-Sectional Study.
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Zafar, Mavrah, Waheed, Gulfreen, Khurshid, Sehar, and Zareen, Aneela
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RESPIRATORY diseases , *MECONIUM aspiration syndrome , *NEONATAL intensive care units , *NEWBORN infants , *TERTIARY care - Abstract
Background: Respiratory diseases constitute a significant contributor to health issues in neonates, leading to admissions to neonatal intensive care units (NICU), and many of these neonates never recover, resulting in high neonatal mortality rates with respiratory diseases. Objective: To assess the burden of respiratory diseases in hospitalized neonates and determine their outcomes, including discharges and deaths, among those admitted to neonatal intensive care units in a tertiary care hospital in Lahore. Methods: An observational analytical cross-sectional study was conducted on 187 neonates admitted to a neonatology department of the tertiary care hospital in Lahore. Demographical data was collected by using a structured questionnaire. The analyses were conducted using R software. The chi-square test was employed to ascertain the associations between significant factors of respiratory diseases in neonates. Results: Among the respiratory conditions requiring admission, pneumonia (n=92, 49.1%) stood out as the most frequently diagnosed respiratory disease in neonates, followed by respiratory distress syndrome (RDS) (n=53, 28.3%), transient tachypnea of the newborn (TTN) (n=18, 9.62%), and meconium aspiration syndrome (MAS) (n=24, 12.8%). In terms of mortality among these respiratory conditions, pneumonia had the highest frequency (40.5%), followed by RDS (39.2%), MAS (20.2%), in neonates. Conclusion: Respiratory disorders proved to be a prevalent reason for neonatal admissions to the NICU, showcasing a significant association with neonatal mortality, especially in pneumonia, respiratory distress syndrome, and meconium aspiration syndrome. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Evaluation of the Prevalence of Persistent Pulmonary Hypertension in Neonates (PRE-HIFREQ)
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Renata Bokiniec, MD, Clinical Professor, Head of Department of Neonatology
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- 2022
15. Diagnosis of Transient Tachypnea of Newborn
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Ashraf Mohamed Ibrahim, clinical professor
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- 2022
16. Inhaled Furosemide for Transient Tachypnea of Newborn
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Mariam Rajab, Principal Investigator
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- 2022
17. The Predictive Value of Amniotic Fluid pH and Electrolytes on Neonatal Respiratory Disorders
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Seda Yilmaz Semerci, Postdoctoral Fellow of Neonatology, MD
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- 2022
18. Comparative Study on the Clinical Characteristics of Transient Tachypnea of Newborns according to the Need for Invasive Mechanical Ventilation
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Ho Jun Yoon and Seung Hyun Lee
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transient tachypnea of the newborn ,cesarean section ,noninvasive ventilation ,Pediatrics ,RJ1-570 - Abstract
Purpose Transient tachypnea of the newborn (TTN) is the most prevalent respiratory disease worldwide. Many neonates with TTN generally demonstrate spontaneous improvement. However, only few patients present with severe complications. This study aimed to investigate the differences in clinical features to identify neonates at risk for further complications. Methods Between January 2015 and December 2020, 267 neonates who developed dyspnea within 6 h of birth were delivered at a gestational age of at least 37 weeks. The experimental group (group E) included 44 neonates who required invasive mechanical ventilation, whereas the control group (group C) included 223 neonates who required only observation or non-invasive respiratory support. We analyzed the differences in clinical and perinatal factors between the two groups. Results Gestational age and pH on arterial blood gas analysis at admission were significantly lower in group E (p90 breaths/min), and pneumothorax, were more frequently observed in group E (p90 breaths/min), and need for respiratory assistance (fraction of inspired oxygen concentration ≥0.25) are predictive factors for increased risk of progression to a more severe disease course in neonates with TTN. Additional studies are needed to identify definitive factors that can differentiate TTN that improves spontaneously from TTN that requires intensive care.
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- 2023
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19. Risk Factors and Morbidity in Late-preterm Infants: A Comparison with Early-term and Full-term Infants.
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Eşki, Aykut, Ceylan, Gökhan, and Zenciroğlu, Ayşegül
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PREMATURE infant diseases ,HYPOCALCEMIA ,INFANT mortality ,PNEUMONIA ,MEDICAL records - Abstract
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- 2023
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20. Effect of heated humidified high flow nasal cannula vs bubble nasal continuous positive airway pressure in transient tachypnoea of newborn (>35 weeks)- an open label rct.
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Trisali, Padala and Prasad, K. N. V.
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CONTINUOUS positive airway pressure , *NASAL cannula , *BIRTH weight , *NEWBORN infants , *MATERNAL age - Abstract
"Heated humidified high flow nasal cannula" has developed equally to an alternate respiratory modality to "Bubble Nasal Continuous Positive Airway Pressure" (BNCPAP) for the treatment of late premature newborns who have been diagnosed with "Transient Tachypnea of the Newborn" (TTN). The current study examined neonates >35 weeks gestation diagnosed of Transient Tachypnea of the New-born who were randomly assigned to either "NCPAP or HHHFNC" for treatment. This was an open-label randomised control study that was undertaken at R. L. Jalappa Hospital, which is connected with Sri Devaraj Urs Medical College on new-borns. with >35 weeks of gestational age, admitted to NICU with TTN. With Institutional human ethics committee approval, all qualified participants were enrolled on the research in a systematic manner using "convenient sampling" until the sample size was met. In the present research, there were 84 participants total, with 42 participants assigned to each of the two categories (HHHFNC and BNCPAP). In terms of the percentage of distribution towards maternal age, measure of pregnancy (in weeks), weight at birth, gender, and mode of childbirth, there was no noticeable variation between the two categories. Both groups exhibited excellent recovery, with 97.6 percent of the former and 95.24 percent of the latter. According to the P value of 1.00, in regard to the percentage of people who cured, there was no numerical relevant variation between the Study categories. "HHHFNC" appears to be as efficient and harmless as "BNCPAP" as the basic means of airway management for neonates born with Transient Tachypnea of the Newborn. [ABSTRACT FROM AUTHOR]
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- 2023
21. The effect of non-invasive high-frequency oscillatory ventilation on the duration of non-invasive respiratory support in late preterm and term infants with transient tachypnea of the newborn: a randomized controlled trial.
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Baldan, Emre, Varal, Ipek Guney, Dogan, Pelin, and Cizmeci, Mehmet N.
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PREMATURE infants , *HIGH-frequency ventilation (Therapy) , *NONINVASIVE ventilation , *CONTINUOUS positive airway pressure , *RANDOMIZED controlled trials , *NEWBORN infants , *TACHYPNEA - Abstract
Nasal continuous positive airway pressure (nCPAP) is one of the most commonly used non-invasive respiratory support modes in neonates with transient tachypnea of the newborn (TTN). Non-invasive high-frequency oscillatory ventilation (nHFOV) is a non-invasive respiratory support mode that has been increasingly used in neonatal respiratory disorders. This prospective randomized controlled study compared the efficacy of nHFOV and nCPAP in reducing the duration of non-invasive respiratory support. Late preterm and term infants > 34 weeks' gestation were included in the study. The infants were randomly assigned to receive either nHFOV or nCPAP. Treatment was started with standard settings in both groups. Infants who met treatment failure criteria were switched to nasal intermittent mandatory ventilation for further positive-pressure support. A total of 60 infants were included in the study. Thirty of these infants were included in the nHFOV group and 30 were included in the nCPAP group. The median duration of non-invasive respiratory support was not significantly different between the two groups (21 h [IQR: 16–68] for nHFOV vs 15 h [IQR: 11–33] for nCPAP; p = 0.09). However, after adjusting for potential confounders, nHFOV was associated with a shorter duration of non-invasive respiratory support than nCPAP (adjusted mean difference: 16.3 h; 95% CI: 0.7 to 31.9; p = 0.04). nHFOV was well tolerated and did not increase the risk of complications. Conclusion: Our findings suggest that nHFOV is an effective and safe ventilation mode for late preterm and term neonates with TTN. Trial registry: Clinicaltrials.gov (NCT03006354). Date of registration: December 30, 2016. What is Known: • nHFOV is a ventilation model that has been increasingly used for the management of RDS. • TTN is one of the most common causes of neonatal respiratory distress. What is New: • nHFOV is associated with shorter duration of non-invasive respiratory support and duration of oxygen support. • nHFOV may be a safe and effective alternative to nCPAP for neonates with TTN. [ABSTRACT FROM AUTHOR]
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- 2023
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22. Inhaled Beta-2 Agonist Versus Epinephrine For Treatment of Transient Tachypnea of Newborn (TTN)
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Ahmed Noaman, Lecturer
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- 2021
23. Transient Tachypnea of the Newborn
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Bhering, Carlos A., de Moraes Ramos, José Roberto, Moreira de Sá, Renato Augusto, editor, and Fonseca, Eduardo Borges da, editor
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- 2022
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24. Inhaled Budesonide in Transient Tachypnea of the Newborn
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Dr. Sirin Mneimneh, Pediatrician
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- 2021
25. Efficacy of Misoprostol in Prevention of Neonatal Respiratory Morbidity in Parturient at Early Term Elective Caesarian Section
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Samar Ali, Principal Investigator
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- 2021
26. LUNG ULTRASONOGRAPHY DECREASES RADIATION EXPOSURE (LUDRE)
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H. Tolga Çelik, associate professor
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- 2021
27. Assessment of myocardial function in late preterm and term infants with transient tachypnea of the newborn using tissue Doppler imaging - a pilot observational study.
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Saha, Anindya Kumar, Ghosh, Moumita, Sardar, Syamal, and Pal, Somnath
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PREMATURE infants , *RIGHT ventricular dysfunction , *DOPPLER echocardiography , *FUNCTIONAL assessment , *NEWBORN infants - Abstract
The aim of this study was to compare conventional and tissue Doppler echocardiography parameters between transient tachypnea of the newborn (TTN) and healthy control infants. This cross sectional pilot observational study was conducted in a level 3 neonatal care unit of India. Consecutively born late preterm and term infants (LPTI) with TTN were eligible for enrollment. Control group was selected from healthy LPTI. Conventional and tissue Doppler (myocardial velocities, myocardial performance index (MPI)) echocardiography was done within first 12 h (D1) and 48–72 h (D3) of life. Conventional echocardiography parameters were fractional shortening (FS), ejection fraction (EF), ventricular output, E/A ratio, fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), pulmonary artery systolic pressure (PASP), and pulmonary artery acceleration to ejection time ratio (PATET). Baseline characteristics and echocardiography images were compared between TTN and control groups. Out of 60 infants enrolled, 34 from TTN and 20 from control group were finally analyzed. Mean (SD) gestational age and birth weight of the study population was 366/7(1.8) weeks and 2398(376) g respectively. Left ventricular (LV) parameters were similar between both groups. On D1, right ventricular (RV)e' was smaller (6.42(1) cm/s vs. 7.68(1.68) cm/s, p 0.022), and E/e' (7.79(1.51) vs. 6.08(2.59), p 0.037) was larger in TTN group, indicating RV diastolic dysfunction. RV MPI (0.61(0.11) vs. 0.44(0.12), p < 0.001) was also larger, signifying RV global myocardial dysfunction. Similar findings were observed on D3. PATET was lower in TTN group on both D1 (0.34 (0.05) vs. 0.42 (0.05), p < 0.001) and D3 (0.38 (0.05) vs. 0.43 (0.02), p 0.004) suggesting persistently raised pulmonary arterial pressure, although only 2 infants developed pulmonary hypertension identified by standard echocardiography. Conclusion: Myocardial tissue Doppler imaging of TTN infants revealed occult right ventricular diastolic dysfunction secondary to persistently raised pulmonary arterial pressure. What is Known: •Transient tachypnea of the newborn may be associated with pulmonary arterial hypertension. What is New: •Tissue Doppler imaging in infants with transient tachypnea of the newborn revealed occult right ventricular diastolic dysfunction secondary to raised pulmonary arterial pressure, not detected by standard echocardiography. [ABSTRACT FROM AUTHOR]
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- 2023
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28. Elective cesarean section versus induced vaginal delivery: Do any differences in terms of neonatal respiratory morbidities exist?
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Özdoğar, Mahli Batuhan, Ayar, Murat, Hamitoğlu, Şerif, and Olukman, Özgür
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MATHEMATICAL statistics ,INDUCED labor (Obstetrics) ,TACHYPNEA ,ACADEMIC medical centers ,CONFIDENCE intervals ,PARAMETERS (Statistics) ,NEONATAL diseases ,HOSPITAL care of newborn infants ,RETROSPECTIVE studies ,CASE-control method ,ACQUISITION of data ,GESTATIONAL age ,VAGINA ,RISK assessment ,COMPARATIVE studies ,SEX distribution ,T-test (Statistics) ,MEDICAL records ,BIRTH weight ,DESCRIPTIVE statistics ,CHI-squared test ,CESAREAN section ,DELIVERY (Obstetrics) ,APGAR score ,SOCIODEMOGRAPHIC factors ,LOGISTIC regression analysis ,ODDS ratio ,DISEASE risk factors ,CHILDREN - Abstract
Background/Aim: Transient tachypnea of the newborn (TTN) is mostly a benign and self-limiting common physiological disorder. Certain factors, such as elective cesarean section (CS) not preceded by spontaneous labor, delivery before 39 gestational weeks, and perinatal asphyxia, interfere with the fetal-neonatal transition. In our study, we aimed to review the results of hospitalized newborns who receive a diagnosis of TTN and investigate the possible relationship between the implementation of labor induction and the occurrence of this disorder. Methods: This study used a case-control study design. We scanned the hospital records of 156 term newborns hospitalized between January 2017 and January 2018 who received a diagnosis of TTN and who did not have any additional fetal and/or maternal risk factors. Demographic features, mode of delivery, and implementation of labor induction in vaginal deliveries were recorded and compared to the data from 150 healthy term infants. Infants were then split into two groups according to their type of labor induction, and a separate subgroup analysis was performed in terms of the risk of TTN development. Results: The incidence of TTN was 2.9% in vaginal deliveries and 8.5% in CSs. Differences between groups regarding gestational age, birth weights, gender, elective induction in vaginal deliveries, interventions in the delivery room, and types of intervention were found (P<0.05). The risk of developing TTN was 2.5 times higher in the induction group compared to those who did not receive induction but still developed TTN (P<0.001). Also, the risk was significantly higher in the induction group compared to those who did not receive induction and did not develop TTN (P<0.001). After applying a logistic regression analysis, labor induction (odds ratio: 1.005; 95% confidence interval: 1.003-1.008, P<0.001) was found to be an independent significant risk factor for developing TTN. Conclusions: This study indicates that infants born via electively induced vaginal delivery had significantly higher rates of TTN. Therefore, elective labor induction can be added as a new risk factor for TTN development. In our opinion, labor induction without valid medical and obstetric indications should be avoided due to maternal and fetal complications. [ABSTRACT FROM AUTHOR]
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- 2023
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29. Comparison of Effects of Inhaled Salbutamol with Placebo in Management of Transient Tachypnea of Newborn
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Khaista Rehman, Fahim Ahmed Subhani, Sajid Ali Shah, Bilal Ahmed, Ammara Ayub, and Saba Afzal Sheikh
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Hospital Stay ,Oxygen Inhalation ,Salbutamol ,Transient tachypnea of the newborn ,Medicine ,Medicine (General) ,R5-920 - Abstract
Objective: To compare the outcome of inhaled Salbutamol (Albuterol) with normal saline (Placebo) in terms of mean duration of oxygen therapy and mean hospital stay in newborns with transient tachypnea of the newborn. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Paediatrics, Islamic International Medical College, Trust Pakistan Railway General Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: One hundred newborns meeting the inclusion criteria were enrolled. All newborns included in this study had X-ray chests. Neonates were divided into Groups A and B by lottery method. Group-A received inhaled Salbutamol plus 2 ml normal saline 0.9% by nebulizer, and Group-B received 0.9% normal saline by nebulizer six hourly and outcomes were recorded. Results: In this study, 32(32%) patients were female newborns, and 68(68%) were male babies. 97(97%) babies were delivered by Caesarean section. In Salbutamol-Group, the mean duration of oxygen inhalation was 20.86±10.79 hours, while in PlaceboGroup, the mean was 40.42±16.64 hours (p-value
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- 2023
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30. The diagnostic value of n-terminal probrain natriuretic peptides to differentiate neonatal pneumoniae and transient tachypnea of the newborn.
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ARSLAN, Zeynep, ALAN, Serdar, and ALİEFENDİOĞLU, Didem
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BRAIN natriuretic factor , *NATRIURETIC peptides , *NEONATAL intensive care units , *NEWBORN infants , *LUNGS , *TACHYPNEA - Abstract
Background/aim: The primary objective of the study was to determine the diagnostic value of serum N-terminal probrain natriuretic peptide (NT-proBNP) levels to differentiate neonatal pneumonia (NP) and transient tachypnea of the newborn (TTN). The secondary objective was to investigate the prognostic role of NT-proBNP levels in neonates with severe respiratory distress (RD). Materials and methods: A prospective, observational, single-blinded study involving 58 late preterm and term newborns who were diagnosed with TTN or NP was conducted between June 2020 and June 2021 at a level-3 neonatal intensive care unit in Kırıkkale University Faculty of Medicine. TTN and NP groups were compared for serum NT-proBNP levels measured at the 1st and 24th hours of life. Optimal cut-off NT-proBNP value was determined by Youden index to predict the diagnosis of NP. Lung ultrasound was used to support the diagnosis of TTN and NP. In addition, lung ultrasound score (LUS) was used to determine severe RD. Results: The median of NT-proBNP level was significantly higher at the 24th hour of life in the NP group than in the TTN group, respectively 7263.5 pg/mL (1643-35,000) and 3308 pg/mL (69-19,746), p = 0.004. At a cut-off value of 5515.5 pg/mL, NT-proBNP had a sensitivity of 75% and specificity of 73.8% to predict NP [AUC= 0.749 (95% CI: 0.602-0.895; p = 0.004)]. The study population was divided into two groups as high score group (n: 23, LUS = 7) and low score group (n: 35, LUS < 7) according to the LUS at the 6th hour of life. NT-proBNP values at 24th hour of life were 6320 pg/mL (69-35,000) in high score group and 3500 pg/mL (570-15,948) in low score group, p = 0.044. Duration of oxygen support (p = 0.006), noninvasive ventilation (p = 0.008) and NICU stay (p = 0.004) were higher in high-score group. Conclusion: NT-proBNP values at 24th hour of life can be used as a relatively early predictor in the differentiation between NP and TTN in late preterm and term neonates. In addition, elevated NT-proBNP values are related to the higher LUS which reflects the severity of RD regardless of diagnosis. [ABSTRACT FROM AUTHOR]
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- 2023
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31. Cardiopulmonary Ultrasound Patterns of Transient Acute Respiratory Distress of the Newborn: A Retrospective Pilot Study.
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Pierro, Maria, Chioma, Roberto, Benincasa, Consuelo, Gagliardi, Giacomo, Amabili, Lorenzo, Lelli, Francesca, De Luca, Giovanni, and Storti, Enrico
- Subjects
ADULT respiratory distress syndrome treatment ,ECHOCARDIOGRAPHY ,PILOT projects ,ULTRASONIC imaging ,TACHYPNEA ,LUNGS ,DURATION of pregnancy ,RETROSPECTIVE studies ,ADULT respiratory distress syndrome ,ARTIFICIAL respiration ,VASCULAR resistance ,CHILDREN - Abstract
Acute transient respiratory distress in the first hours of life is usually defined as transient tachypnea of the newborn (TTN). TTN is a respiratory self-limiting disorder consequent to delayed lung fluid clearance at birth. While TTN is the most common etiology of respiratory distress near term, its pathogenesis and diagnostic criteria are not well-defined. Lung ultrasound and targeted neonatal echocardiography are increasingly being used to assess critically ill infants, although their combined use to improve diagnostic precision in neonatal intensive care units has not yet been described. This retrospective pilot analysis aimed to identify possible cardiopulmonary ultrasound (CPUS) patterns in term and late preterm infants suffering from transient respiratory distress and requiring non-invasive respiratory support. After retrospectively revising CPUS images, we found seven potential sonographic phenotypes of acute neonatal respiratory distress. Up to 50% of the patients presented with signs of increased pulmonary vascular resistance, suggesting that those patients may be diagnosed with mild forms of persistent pulmonary hypertension of the newborn. Approximately 80% of the infants with a history of meconium-stained amniotic fluid displayed irregular atelectasis, indicating that they may have suffered from mild meconium aspiration syndrome. CPUS evaluation may improve accuracy in the approach to the infants presenting with transient acute respiratory distress, supporting communication with the parents and carrying important epidemiological consequences. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
32. Comparison of urine bisphenol A levels in transient tachypnea of the newborn and healthy newborns.
- Author
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Büyükeren, Melek
- Abstract
Background. To investigate the relationship between neonatal urine bisphenol A (BPA) levels and the prevalence and prognosis of transient tachypnea of the newborn (TTN). Methods. This prospective study was conducted between January and April 2020 in the Neonatal Intensive Care Unit (NICU) of Gaziantep Cengiz Gökçek Obstetrics and Pediatric Hospital. The study group consisted of patients diagnosed with TTN and the control group was made up of healthy neonates housed together with their mothers. Urine samples were collected from the neonates within the first 6 hours postnatally. Results. Urine BPA levels and urine BPA/creatinine levels were statistically higher in the TTN group (P < 0.005). The receiver operating characteristic (ROC) curve analysis determined the cut-off value of urine BPA for TTN to be 1.18 µg/L (95% confidence interval [CI]: 0.667-0.889, sensitivity: 78.1%, and specificity: 51.5%) and the cut-off value of urine BPA/creatinine to be 2.65 µg/g (95% CI: 0.727-0.930, sensitivity: 84.4%, and specificity: 66.7%). Furthermore, the ROC analysis indicated that the cut-off value of BPA for neonates requiring invasive respiratory support was 15.64 µg/L (95% CI: 0.568-1.000, sensitivity: 83.3%, and specificity: 96.2%) and the cut-off value for BPA/creatinine was 19.10 µg/g (95% CI: 0.777-1.000, sensitivity: 83.3%, and specificity: 84.6%) among the TTN patients. Conclusions. BPA and BPA/creatinine values were higher in the urine of newborns diagnosed with TTN which is a fairly common cause of NICU hospitalization, in samples collected within the first 6 hours after birth, which may be a reflection of intrauterine factors. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
33. Newborn Medicine
- Author
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Mancuso, Thomas J., Holzman, Robert S., Mancuso, Thomas J., Cravero, Joseph P., and DiNardo, James A.
- Published
- 2021
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34. Transient Tachypnea of the Newborn: Pathogenesis, Diagnosis, Treatment
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Evgenii V. Shestak and Olga P. Kovtun
- Subjects
transient tachypnea of the newborn ,respiratory failure ,pathogenesis ,risk factors ,differential diagnosis ,non-invasive respiratory therapy ,cpap ,Pediatrics ,RJ1-570 - Abstract
The review provides up-to-date information on the development of transient tachypnea of the newborn (TTN) considering early postnatal period physiology and pathophysiological processes. Data on risk factors of TTN development, feature of disease course, and its differential diagnosis are presented. Traditional treatment methods for patients with TTN as well as results of modern studies on efficacy of non-invasive respiratory support are covered.
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- 2022
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35. Does antenatal corticosteroid therapy improve neonatal outcomes in late preterm birth?
- Author
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Ustun, Nuran, Hocaoğlu, Meryem, Turgut, Abdülkadir, Arslanoğlu, Sertaç, and Ovalı, Fahri
- Subjects
- *
PREMATURE labor , *JAUNDICE , *CONTINUOUS positive airway pressure , *NEONATAL intensive care , *RESPIRATORY distress syndrome , *OXYGEN therapy - Abstract
Background Infants who are born at 34°/7 to 366/7 weeks of gestation (late preterm) are at greater risk for respiratory and other neonatal morbidities. The objective of this study was to examine the effects of the administration of antenatal corticosteroids (ACS) to women at risk for late preterm delivery on the incidence of neonatal outcomes. Method This was a prospective cohort study of singleton gestations at risk of imminent delivery between 34°/7 and 366/7 weeks. Neonatal outcomes were compared between mothers who received ACS and those who did not. The primary outcome was the rate of composite respiratory morbidity defined as the need for treatment within 72 h of life (continuous positive airway pressure or high flow nasal cannula for least 2 h or supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least four continuous hours or mechanical ventilation). Results During the 3-year study period, 595 subjects were included in this study, comprising 234 subjects that received ACS and 361 that did not. Administration of ACS significantly reduced the rates of composite respiratory morbidity (aOR 0.63 95% CI 0.40–0.99), the use of CPAP or HFNC for at least 2 h (aOR 0.57 95% CI 0.35–0.94), and transient tachypnea of the newborn (aOR 0.48 95% CI 0.28–0.82). Neonatal hypoglycemia was more significantly increased in the ACS group compared with controls (aOR 1.64 95% CI 1.04–2.59). We found no significant between-group differences in the rate of respiratory distress syndrome, surfactant use, need for resuscitation, jaundice requiring phototherapy, admission to neonatal intensive care or special care nursery, and duration of hospitalization. Conclusion Administration of ACS during the late preterm period decreased neonatal respiratory complications, however, increased the rate of hypoglycemia. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
36. Comparison of Effects of Salbutamol Inhalation with Continuous Positive Airway Pressure and Bubble Continuous Positive Airway Pressure Alone in the Management of Severe Transient Tachypnea of the Newborn.
- Author
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Afzal, Warda, Zaidi, Syed Taqi Hasan, Saba, Ameena, Shujaat, Wasif, Fatima, Benish, and Maqsood, Almas
- Subjects
- *
CONTINUOUS positive airway pressure , *INHALATION injuries , *ALBUTEROL , *NEONATAL intensive care units , *TACHYPNEA , *NEWBORN infants - Abstract
Objective: To find the frequency of known risk factors in cases of severe transient tachypnea of the newborn (TTN) and to measure the effect of inhaled Salbutamol to bubble CPAP on required treatment duration. Study Design: Quasi-experimental study. Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Jun 2020. Methodology: A total of 60 cases of severe TTN, labelled on a predefined criterion were included in the study. The sample was randomized into two groups using an alternate sampling technique. Group-A was treated with bubble CPAP alone, while in Group-B, inhaled Salbutamol was added. The response was measured regarding the time taken to settle respiratory distress. Results: Out of 60 cases, 54(90.0%) were delivered through Caesarean section. A total of 9(15.0%) cases were born prematurely. Polycythemia was found in 10(16.6%) cases. Maternal asthma and gestational diabetes frequency were 8(13.33%) and 12(20.0%), respectively. A significant reduction was seen in the duration of respiratory distress in the study population receiving bubble CPAP with inhaled Salbutamol in the first 24 hours of illness (p-value<0.001). Conclusion: Caesarean section is the most significant risk factor for developing TTN. Adding Salbutamol nebulization to bubble CPAP resulted in an earlier settlement of respiratory distress. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
37. The Possible Effect Of Amniotic Fluid pH On Neonatal Morbidities In Maternal Inflammation/Infection Associated Pregnancies
- Author
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Seda Yilmaz Semerci, Fellowship of Neonatology
- Published
- 2019
38. The Role of Sustained Inflation on Short Term Respiratory Outcomes in Term Infants
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Merih Cetinkaya, Associate Professor, MD,PhD
- Published
- 2019
39. Left atrial strain assessment unveils left ventricular diastolic dysfunction in neonates with transient tachypnea of the newborn: A prospective observational study.
- Author
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Ficial B, Dolce P, Petoello E, Flore AI, Nogara S, Ciarcià M, Brancolini G, Alfarano A, Marzollo R, Bosio I, Raimondi F, Risso FM, Beghini R, Dani C, Benfari G, Ribichini FL, and Corsini I
- Subjects
- Humans, Infant, Newborn, Prospective Studies, Female, Male, Lung physiopathology, Lung diagnostic imaging, Diastole, Case-Control Studies, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Left diagnostic imaging, Transient Tachypnea of the Newborn physiopathology, Heart Atria physiopathology, Heart Atria diagnostic imaging, Echocardiography
- Abstract
Introduction: An inadequate clearance of lung fluid plays a key role in the pathogenesis of transient tachypnea of the newborn (TTN)., Objectives: To evaluate if left ventricular diastolic dysfunction contributes to reduced clearance of lung fluid in TTN., Materials and Methods: This was a prospective, observational study. Echocardiography and lung ultrasound were performed at 2, 24 and 48 h of life (HoL) to assess biventricular function and calculate lung ultrasound score (LUS). Left atrial strain reservoir (LASr) provided surrogate measurement of left ventricular diastolic function., Results: Twenty-seven neonates with TTN were compared with 27 controls with no difference in gestation (36.1 ± 2 vs. 36.9 ± 2 weeks) or birthweight (2508 ± 667 vs. 2718 ± 590 g). Biventricular systolic function was normal in both groups. LASr was significantly lower in cases at 2 (21.0 ± 2.7 vs. 38.1 ± 4.4; p < 0.01), 24 (25.2 ± 4.5 vs. 40.6 ± 4.0; p < 0.01) and 48 HoL (36.5 ± 5.8 and 41.6 ± 5.2; p < 0.01), resulting in a significant group by time interaction (p < 0.001), after adjusting for LUS and gestational diabetes. A logistic regression model including LUS, birth weight and gestational diabetes as covariates, showed that LASr at 2 HoL was a predictor of respiratory support at 24 HoL, with an adjusted odds ratio of 0.60 (CI 0.36-0.99)., Conclusions: LASr was reduced in neonates with TTN, suggesting diastolic dysfunction, that may contribute to the delay in lung fluid clearance., (© 2024 Wiley Periodicals LLC.)
- Published
- 2024
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40. Newborn Chest
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Levin, Jonathan C., Cleveland, Robert H., Kourembanas, Stella, Cleveland, Robert H., editor, and Lee, Edward Y., editor
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- 2020
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41. Fluid handling and blood flow patterns in neonatal respiratory distress syndrome versus transient tachypnea: a pilot study
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Ismail Rana, Murthy Prashanth, Abou Mehrem Ayman, Liang Zhiying, and Stritzke Amelie
- Subjects
Dopplers ,Transient tachypnea of the newborn ,Respiratory distress syndrome ,Renal transition ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Cardiovascular and renal adaptation in neonates with Respiratory Distress Syndrome (RDS) and Transient Tachypnea of the Newborn (TTN) may be different. Methods Neonates ≥32 weeks were diagnosed with RDS or TTN based on clinical, radiologic and lung sonographic criteria. Weight loss, feeding, urine output, and sodium levels were recorded for the first 3 days, and serial ultrasounds assessed central and organ Doppler blood flow. A linear mixed model was used to compare the two groups. Results Twenty-one neonates were included, 11 with TTN and 10 with RDS. Those with RDS showed less weight loss (− 2.8 +/− 2.7% versus − 5.6 +/− 3.4%), and less enteral feeds (79.2 vs 116 ml/kg/day) than those with TTN, despite similar fluid prescription. We found no difference in urine output, or serum sodium levels. Doppler parameters for any renal or central parameters were similar. However, Anterior Cerebral Artery maximum velocity was lower (p = 0.03), Superior Mesenteric Artery Resistance Index was higher in RDS, compared to TTN (p = 0.02). Conclusion In cohort of moderately preterm to term neonates, those with RDS retained more fluid and were fed less on day 3 than those with TTN. While there were no renal or central blood flow differences, there were some cerebral and mesenteric perfusion differences which may account for different pathophysiology and management.
- Published
- 2021
- Full Text
- View/download PDF
42. Comparison of Effects of Salbutamol Inhalation with Continuous Positive Airway Pressure and Bubble Continuous Positive Airway Pressure Alone in the Management of Severe Transient Tachypnea of the Newborn
- Author
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Warda Afzal, Syed Taqi Hasan Zaidi, Ameena Saba, Wasif Shujaat, Benish Fatima, and Almas Maqsood
- Subjects
Bubble CPAP ,Inhaled salbutamol ,Risk factors ,Transient tachypnea of the newborn ,Medicine ,Medicine (General) ,R5-920 - Abstract
Objective: To find the frequency of known risk factors in cases of severe transient tachypnea of the newborn (TTN) and to measure the effect of inhaled Salbutamol to bubble CPAP on required treatment duration. Study Design: Quasi-experimental study. Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Jun 2020. Methodology: A total of 60 cases of severe TTN, labelled on a predefined criterion were included in the study. The sample was randomized into two groups using an alternate sampling technique. Group-A was treated with bubble CPAP alone, while in Group-B, inhaled Salbutamol was added. The response was measured regarding the time taken to settle respiratory distress. Results: Out of 60 cases, 54(90.0%) were delivered through Caesarean section. A total of 9(15.0%) cases were born prematurely. Polycythemia was found in 10(16.6%) cases. Maternal asthma and gestational diabetes frequency were 8(13.33%) and 12(20.0%), respectively. A significant reduction was seen in the duration of respiratory distress in the study population receiving bubble CPAP with inhaled Salbutamol in the first 24 hours of illness (p-value
- Published
- 2022
- Full Text
- View/download PDF
43. Role of Salbutamol in The Management of Transient Tachypnea of the Newborn: A Comparative Prospective Study
- Author
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Waqas Ahmed, Ali Mujtaba Tahir, Fahim Ahmed Subhani, Zeeshan Ahmed, Amina Sohail, and Hafsa Javed
- Subjects
Nebulization ,Normal saline ,Respiratory rate ,Salbutamol ,Transient tachypnea of the newborn ,Medicine ,Medicine (General) ,R5-920 - Abstract
Objective: To compare the outcome of Salbutamol nebulization with normal saline (placebo) in transient tachypnea of the newborn. Study Design: Comparative prospective study. Place and Duration of Study: Department of Neonatal Medicine, Military Hospital Rawalpindi, from Jan 2017 to Mar 2018. Methodology: Sixty term neonates with respiratory rate >60 breaths/min and transient tachypnea of newborn score of ≥4 were enrolled. They were randomly allocated to two equal groups. Group-1 received Salbutamol nebulization (0.15 mg/kg) while Group-2 received normal Saline (placebo) nebulization. Results: The mean gestational age was 38.31±1.28 weeks, while the average birth weight was 2.97±0.27 kg. The mean change in transient tachypnea of newborn score with Salbutamol nebulization was 5.63±1.22, while 0.63±1.54 with normal Saline nebulization. Likewise, the mean change in respiratory rate with Salbutamol was 9.80±2.05, while -3.73±2.57 with normal saline. Conclusion: This study demonstrated nebulized Salbutamol as an effective tool in reversing transient tachypnea of newborns with decreasing respiratory rate compared to normal saline nebulization (placebo).
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- 2022
- Full Text
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44. Risk factors associated with neonatal infectious and respiratory morbidity following preterm premature rupture of membranes.
- Author
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Kacperczyk-Bartnik, Joanna, Bartnik, Pawel, Teliga-Czajkowska, Justyna, Malinowska-Polubiec, Aneta, Dobrowolska-Redo, Agnieszka, Romejko-Wolniewicz, Ewa, Sierdzinski, Janusz, Golawski, Ksawery, and Czajkowski, Krzysztof
- Subjects
BRONCHOPULMONARY dysplasia ,NEONATAL infections ,NEONATAL sepsis ,PREMATURE labor ,RESPIRATORY distress syndrome - Abstract
Objectives: Preterm premature rupture of membranes (pPROM) is associated with the increased risk of chorioamnionitis, foetal exposure to inflammation, and respiratory complications in preterm neonates. The aim of the study was to identify patients at highest risk of developing neonatal infectious and respiratory morbidity following pPROM and preterm birth. Material and methods: It was a retrospective cohort study including 299 consecutive patients in singleton pregnancies complicated by preterm premature rupture of membranes and giving birth between 22
nd and 36th gestational week. Analysed factors included maternal characteristics, obstetric history, gestational age at pPROM and at delivery, latency and management. Multivariate logistic regression models were applied in order to identify risk factors for severe infectious and respiratory neonatal complications. Results: Earlier gestational age at pPROM is associated with increased probability of developing early-onset neonatal sepsis and pulmonary hypertension. Earlier gestational age at birth and lower birth weight were independent factors associated with neonatal respiratory distress syndrome. Positive cervical culture was identified as a risk factor for acute neonatal respiratory failure. Conclusions: Gestational age at pPROM, gestational age at birth and birth weight were the leading factors influencing the risk of developing neonatal infectious and respiratory morbidity following preterm premature rupture of membranes. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
45. New parameters on prediction of severity of transient tachypnea of the newborn.
- Author
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ÇELİK, Yusuf, KAHVECİOĞLU, Dilek, ECE, İbrahim, ATİK, Fatih, KÖSE ÇETİNKAYA, Aslıhan, and TAŞAR, Medine Ayşin
- Subjects
- *
PLATELET count , *CONTINUOUS positive airway pressure , *MEAN platelet volume , *ERYTHROCYTES , *LOGISTIC regression analysis , *TACHYPNEA , *SYSTOLIC blood pressure - Abstract
Background/aim: Transient tachypnea of the newborn (TTN) is a common clinical problem that often occurs in the first hours of life. Although it is considered to be a benign clinical course, some cases may have severe symptoms and require ventilation support. In this study, we aimed to determine the association between the mean platelet volume (MPV), nucleated red blood cells (NRBCs), right ventricular systolic pressure (RVSP), and the severity of TTN. Materials and methods: Patients with TTN were divided into two groups according to Silverman score (<7: group 1 [n: 34] and ≥7: Group 2 [n: 30]). The groups were compared in terms of demographic characteristics, hematologic parameters, and RVSP within the first 24 hours after admission. Results: Mean birth weight of the patients was 3033.4 ± 364.1 g and median gestational age was 38 weeks (min-max: 34-42). Patients in Group 2 were found to require higher nasal continuous positive airway pressure (nCPAP) support and longer duration of oxygen treatment (p: 0.001). Patients in Group 2 had significantly higher thrombocyte, absolute NRBCs count, NRBCs/100 WBCs, and RVSP levels (p < 0.05). Hemoglobin and hematocrit levels were found significantly higher in group 1(p < 0.05). In logistic regression analysis, NRBCs/100 WBCs was found to be the most important independent parameter that affects Silverman score at admission (OR: 7.065, CI: 1.258-39.670, p: 0.026). Conclusion: This is the first study that investigates the association between NRBCs, RVSP, and severity of TTN. We think that elevated NRBCs and RVSP values are helpful for clinicians in decision making for referral of the patients to a secondary or a tertiary level of NICU and also inform the families about prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
46. Antenatal Corticosteroids Decrease the Risk of Composite Neonatal Respiratory Morbidity in Planned Early Term Cesarean Deliveries.
- Author
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DeBolt, Chelsea A., Johnson, Shaelyn, Harishankar, Krupa, Monro, Johanna, Kaplowitz, Elianna, Bianco, Angela, and Stone, Joanne
- Subjects
- *
PREVENTIVE medicine , *ADRENOCORTICAL hormones , *PREMATURE infants , *CONFIDENCE intervals , *NEONATAL diseases , *LUNGS , *FISHER exact test , *MANN Whitney U Test , *T-test (Statistics) , *DESCRIPTIVE statistics , *CHI-squared test , *PRENATAL care , *CESAREAN section , *RESPIRATORY distress syndrome , *DATA analysis software , *LOGISTIC regression analysis , *LONGITUDINAL method - Abstract
Objective While administration of antenatal corticosteroids prior to term elective cesarean deliveries has been shown in international randomized controlled trials to decrease the rates of respiratory distress syndrome and transient tachypnea of the newborn, this is not a standard practice in the United States. We aim to determine if the administration of antenatal corticosteroids for fetal lung maturation within 1 week of scheduled early term cesarean delivery resulted in decreased composite respiratory morbidity. Study Design Historical cohort study including women who underwent scheduled early term cesarean delivery of a singleton, non-anomalous neonate at Mount Sinai Hospital between May 2015 and August 2019, comparing those who completed a course of antenatal corticosteroids within 1 week of delivery to those who did not. The primary outcome was composite respiratory morbidity defined as respiratory distress syndrome, transient tachypnea of the newborn, and neonatal intensive care unit admission for respiratory morbidity. Maternal and neonatal characteristics were compared between groups using t -tests or Wilcoxon-Rank Sum tests for continuous measures and Chi-square or Fisher's exact tests for categorical measures, as appropriate. The outcomes were assessed using logistic regression. Results History of preterm birth was significantly higher in those who received antenatal corticosteroids compared with those who did not (24.0 vs. 10.9%, p = 0.01). Neonates who were not exposed to antenatal corticosteroids were more likely to experience the composite respiratory morbidity compared with those who were exposed (RR 4.1, 95% CI 1.2–13.7; p = 0.02). Between 37 and 38 weeks, neonates who did not receive steroids were at increased risk of composite respiratory morbidity (RR 11.7, 95% CI 1.5–89.0, p < 0.01), however, there was no difference for those born between 38 and 39 weeks. Conclusion Betamethasone course administered prior to planned early term cesarean delivery was associated with a statistically significant reduction in the neonatal composite respiratory morbidity compared with routine management. Key Points Steroids administered prior to scheduled cesarean lead to decreased neonatal respiratory morbidity. Steroid administration was not associated with increased adverse neonatal outcomes. Steroid administration was most beneficial between 37 and 38 weeks. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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47. Effect of Supine or Prone Position After Caesarean Birth
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Orna Rosen, Asst Prof., Dept of Pediatrics (Neonatology)
- Published
- 2018
48. Misoprostol Before Elective Caesarean Section for Decreasing the Neonatal Respiratory Morbidity
- Author
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Ahmed Mohamed El Kotb Abdel Fattah, Dr., Lecturer in obstertics and gynecology, Ain Shams University Hospital
- Published
- 2018
49. Comparison of inhaled salbutamol and intravenous furosemide in the treatment of transient tachypnea of the newborn regarding their safety and efficacy.
- Author
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Sabry, Amira M., Azeem, Mohammed A. A., Ismail, Marwa M., El Khatib, Dina H. E. D. H., and AbdelAziz, Iman A.
- Subjects
- *
TACHYPNEA , *FUROSEMIDE , *DRUG therapy , *HOSPITAL care , *ALBUTEROL - Abstract
Postnatal respiratory complications among term infants are common. The most commonly reported cause of neonatal respiratory distress is transient tachypnea of the newborn (TTN), with an estimated incidence of 0.5-2.8% of all newborns. Aim To evaluate and compare the efficacy and safety of inhaled salbutamol and intravenous (i.v.) furosemide in the treatment of TTN and to monitor of their possible adverse effects in neonates. Patients and methods This was a randomized controlled clinical trial on 100 neonates who were admitted immediately or shortly after birth owing to persistence of tachypnea to neonatal intensive care unit of pediatric hospitals, Cairo University, over a 1-year period. Our study included 100 neonates (25 in the salbutamol group, 25 in the furosemide group, and 50 in the control group) with TTN born between 35 and 39 weeks of gestational age. They were randomized in a blinded manner to receive one nebulized dose of salbutamol 0.15 mg/kg in 0.9% saline solution or i.v. furosemide 1 mg/kg once in addition to oxygen and i.v. fluids or received oxygen and i.v. fluids alone. Results The efficacy of inhaled salbutamol and furosemide was assessed by determining the respiratory rate, heart rate, TTN clinical score, and the level of respiratory support before receiving medication and 30 min, 1, and 4 h after drug therapy. The duration and level of respiratory support and the period of hospitalization were shorter in the salbutamol group. There was a significant decrease in the respiratory rate and TTN score in the salbutamol group 4 h after nebulized salbutamol. Conclusion Comparing the three groups after respiratory support, TTN score was significantly improved in the salbutamol group. The total duration of oxygen treatment in hours and total neonatal intensive care unit stay in days were significantly shorter in the salbutamol group than in furosemide and control groups. Regarding the safety of salbutamol, our study did not show a significant difference in adverse effects. Inhaled salbutamol treatment was effective in TTN without adverse events. Further studies at larger or repeated doses of furosemide may be needed. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
50. Increased airway liquid volumes at birth impair cardiorespiratory function in preterm and near-term lambs.
- Author
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Shigeo Yamaoka, Crossley, Kelly J., McDougall, Annie R. A., Rodgers, Karyn, Zahra, Valerie A., Moxham, Alison, Te Pas, Arjan B., McGillick, Erin V., and Hooper, Stuart B.
- Subjects
CESAREAN section ,DELIVERY (Obstetrics) ,LAMBS ,AIRWAY (Anatomy) ,BLOOD flow - Abstract
Respiratory distress is relatively common in infants born at or near-term, particularly in infants delivered following elective cesarean section. The pathophysiology underlying respiratory distress at term has largely been explained by a failure to clear airway liquid, but recent physiological evidence has indicated that it results from elevated airway liquid at the onset of air-breathing. We have investigated the effect of elevated airway liquid volumes at birth on cardiorespiratory function in preterm and near-term lambs. Preterm (130 ± 0 days gestation, term °147 days gestation; n = 12) and near-term (139 ± 1 days gestation; n = 13) lambs were instrumented (to measure blood pressure, blood flow, and blood gas status) and, at delivery, airway liquid volumes were adjusted to mimic levels expected following vaginal delivery (Controls; °7 mL/kg) or elective cesarean section with no labor (elevated liquid (EL); 37 mL/kg). Lambs were delivered, mechanically ventilated, and monitored for blood gas status, oxygenation, ventilator requirements, blood flows (carotid artery and pulmonary artery), and blood pressure during the first few hours of life. Preterm and near-term EL lambs had poorer gas exchange and required greater ventilatory support to maintain adequate oxygenation. Pulmonary blood flow was reduced and carotid artery blood flow, mean arterial blood pressure, and heart rate were reduced in EL near-term but not preterm lambs. These data provide further evidence that greater airway liquid volumes at birth adversely affect newborn cardiorespiratory function, with the effects being greater in near-term newborns. NEW & NOTEWORTHY We provide evidence for adverse effects of elevated airway liquid volumes at birth on pulmonary blood flow and gas exchange in both preterm and near-term lambs, although the effects were greatest in near-term newborns. Our study is an important step toward understanding the fundamental physiology underlying the cardiorespiratory morbidity associated with near-term newborns with elevated airway liquid volumes leading to respiratory distress soon after birth. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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