Yenidoğan Yoğun Bakım Ünitesinde Respiratuvar Distres Sendromu Tanısıyla Takip Edilen Prematüre Yenidoğanların Surfaktan Cevabının Retrospektif Değerlendirilmesi

Abstract

Amaç: Preterm doğum yenidoğan ölümlerinin önde gelen nedenidir. Bu ölümlerin arasında en yüksek oran solunum sıkıntısı sendromu’ na (RDS) aittir. Bu çalışmanın amacı, yenidoğanlarda RDS yönetiminin en uygun ve etkin hale getirilmesine yardımcı olmak için; RDS’nin risk faktörlerini, klinik özelliklerini ve komplikasyonlarını belirlemektir. Gereç ve Yöntemler: Çalışmaya ikinci düzey yenidoğan yoğun bakım servisimizdeki Ocak 2016 ile Haziran 2021 tarihleri arasında düşük doğum ağırlıklı bebekler alındı. Olgular geriye dönük incelenerek, demografik özellikleri, verilmiş olan tedaviler (mekanik ventilasyon, surfaktan), ve erken ve geç komplikasyonları; ölüm oranları ve sebepleri belirlendi. Bulgular: Toplam 130 olgu çalışmaya alındı. Yüzde altmış ikisi erkek, %38’i kızdı.Yüzde 85’i sezaryen doğum, % 15’inde normal vajinal yoldu. Ortalama doğum ağırlığı 2043±372 gr, ortalama gebelik haftası 32±5 hafta bulundu. Antenatal steroid (ACS), %67,6' sında uygulanmıştı.Yüzde otuzüçünde erken membran rüptürü (EMR) saptandı. Erken ve geç komplikasyonlar; %3,8’inde ventilatöre bağlı pnömoni ve %3’ünde pnömotoraks idi.Yüzde 4,6’ında ise sepsis saptandı. Bronkopulmoner displazi (BPD) %2,3, Prematür Retinopatisi (ROP) %1,5, periventriküler lökomalazi %1,7 ile intrakraniyal kanama (IKK evre III-IV) %2 olarak görüldü. Ölüm oranı %10’du. Sonuç: Ölüm oranlarımız; ülkemizden yayınlanan verilerle benzer olarak bulundu. Doğum öncesi izlemin iyileştirilmesi, gebe takiplerinin düzenli yapılması, sık görülen ölüm nedenleri için risklerin tespit edilip bunlara karşı yeterli ve etkin önlemlerin alınması durumunda ölüm oranlarımızın azalacağını düşünmekteyiz.

Keywords

• Prematürite
• respiratuvar distres sendromu
• surfaktan
• yenidoğan

Retrospective Evaluation of Surfactant Response in Premature Newborns Followed Up with the Diagnosis of Respiratory Distress Syndrome in the Neonatal Intensive Care Unit

Abstract

Aim: Preterm birth is the leading cause of neonatal death. The highest rate among these deaths belongs to respiratory distress syndrome (RDS). The aim of this study is to help the most appropriate and effective management of RDS in newborns; To determine the risk factors, clinical features and complications of RDS. Material and Methods: Low birth weight infants in our second level neonatal intensive care unit between January 2016 and June 2021 were included in the study. The cases were examined retrospectively, demographic characteristics, treatments given (mechanical ventilation, surfactant), and early and late complications; death rates and causes were determined. Results: 130 cases were included in the study. Sixty-two percent were boys and 38% were girls. 85% had cesarean section and 15% had normal vaginal delivery. Mean birth weight was 2043±372 g, mean gestational week was 32±5 weeks. Antenatal steroid (ACS) was administered in 67.6% of them. Premature rupture of membranes (PROM) was detected in 33% of them. Early and late complications; Ventilator-associated pneumonia in 3.8% and pneumothorax in 3%. Sepsis was detected in 4.6%. Bronchopulmonary dysplasia (BPD) 2.3%, Retinopathy of Prematurity (ROP) 1.5%, periventricular leukomalacia 1%, 7 with intracranial hemorrhage (IGC stage III-IV) 2%. The death rate was 10%. Conclusion: Our death rates; was found to be similar to the data published in our country. We think that our mortality rates will decrease if prenatal follow-up is improved, pregnant follow-ups are carried out regularly, risks for common causes of death are determined and adequate and effective measures are taken against them.

Keywords

• respiratory distress syndrome
• newborn
• premature
• surfactant

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