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Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores

Yıl 2015, Cilt: 22 Sayı: 3, 158 - 164, 14.12.2015

Öz

Aim: The aim of this study is to evaluate the accuracy of physical and laboratory findings to determine the length of hospital stay and oxygen requirement in patients diagnosed with transient tachypnea of the newborn.

Materials and Methods: Patients with respiratory distress symptoms that last more than 24 hours were admitted to the study. Sixty infants were analysed at the fourth hour and then daily in respect to their retraction scores, respiratory rates, urine outputs, blood gas measurements, and length of hospital stay. Infants were grouped into four categories according to their retraction scores and treatment modalities.

Results: In the multiple regression analysis, the retraction scores and base excesses on the first day together with the urine output of the second-day were found to explain the 73% of the variance in the length of hospital stay and 68,7% of the variance in the oxygen requirement. The most important factor was found to be the retraction score of the first day. Boys were found to have five times higher risk than girls for severe transient tachypnea (OR: 5,06 %95 CI: 1,1-23,3, p: 0,037). Cesarean section, prematurity, and birth weight were not found to be risk factors for severe respiratory insufficiency.

Conclusion: The present study proposes that clinicians may use the retraction scores to predict the length of hospital stay and oxygen requirements in neonates with transient tachypnea. The increase in urine output may be a sign of recovery. Male infants have five times higher risk of severe respiratory insufficiency due to transient tachypnea.

Key Words: Blood Gas Analysis; Neonatology; Neonatal Intensive Care; Respiratory Insufficiency; Transient Tachypnea of The Newborn.

Kaynakça

  • Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child 1966;111:380-5.
  • Hein HA, Ely JW, Lofgren MA. Neonatal respiratory distress in the community hospital: when to transport, when to keep. J Fam Pract 1998;46:284-9.
  • Silverman WA, Andersen DH. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants. Pediatrics 1956;17:1-10.
  • Escobar GJ, Shaheen SM, Breed EM, Botas C, Greene JD, Yoshida CK, et al. Richardson score predicts short-term adverse respiratory outcomes in newborns >/=34 weeks gestation. J Pediatr 2004;145:754-60.
  • Buch P, Makwana AM, Chudasama RK. Usefulness of Downe score as clinical assessment tool and bubble CPAP as primary respiratory support in neonatal respiratory distress syndrome. JPS 2013;5:e176.
  • Tollner U. Early diagnosis of septicemia in the newborn. Clinical studies and sepsis score. Eur J Pediatr 1982;138:331-7.
  • Kasap B, Duman N, Ozer E, Tatli M, Kumral A, Ozkan H. Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 2008 Feb;50:81-4.
  • Guglani L, Lakshminrusimha S, Ryan RM. Transient tachypnea of the newborn. Pediatr Rev 2008;29:e59-65.
  • Aydemir O, Aydemir C, Sarikabadayi YU, Altug N, Erdeve O, Uras N, et al. The role of plasma N-terminal pro-B-type natriuretic peptide in predicting the severity of transient tachypnea of the newborn. Early Hum Dev 2012;88:315-9.
  • Tharaux PL, Dussaule JC, Couette S, Clerici C. Evidence for functional ANP receptors in cultured alveolar type II cells. Am J Physiol 1998;274:L244-51.
  • Pesonen E, Heldt GP, Merritt TA, Sahn DJ, Elias W, Tikkanen I, et al. Atrial natriuretic factor and pulmonary status in premature infants with respiratory distress syndrome: preliminary investigation. Pediatr Pulmonol 1993;15:362-4.
  • Stroustrup A, Trasande L, Holzman IR. Randomized controlled trial of restrictive fluid management in transient tachypnea of the newborn. J Pediatr 2012;160:38-43 e1.
  • Lewis V, Whitelaw A. Furosemide for transient tachypnea of the newborn. Cochrane Database Syst Rev 2002 (1):CD003064.
  • Derbent A, Kargili A, Koca C, Gumus, II, Sevgili S, Simavli S, et al. Serum platelet-activating factor acetylhydrolase activity: relationship with metabolic syndrome in women with history of gestational diabetes mellitus. Gynecol Endocrinol 2011;27:128-33.
  • Rawlings JS, Smith FR. Transient tachypnea of the newborn. An analysis of neonatal and obstetric risk factors. Am J Dis Child 1984;138:869-71.
  • Schatz M, Zeiger RS, Hoffman CP, Saunders BS, Harden KM, Forsythe AB. Increased transient tachypnea of the newborn in infants of asthmatic mothers. Am J Dis Child 1991;145:156-8.
  • Dani C, Reali MF, Bertini G, Wiechmann L, Spagnolo A, Tangucci M, et al. Risk factors for the development of respiratory distress syndrome and transient tachypnoea in newborn infants. Italian Group of Neonatal Pneumology. Eur Respir J 1999;14:155-9.
  • Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol1995;102:101-6.
  • Riskin A, Abend-Weinger M, Riskin-Mashiah S, Kugelman A, Bader D. Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key. Am J Perinatol 2005;22:377-82.
  • Weintraub AS, Cadet CT, Perez R, DeLorenzo E, Holzman IR, Stroustrup A. Antibiotic use in newborns with transient tachypnea of the newborn. Neonatology 2013;103:235-40.

Journal of Turgut Ozal Medical Center

Yıl 2015, Cilt: 22 Sayı: 3, 158 - 164, 14.12.2015

Öz

Amaç: Çalışmamızda yenidoğanın geçici takipnesi tanılı hastaların hastanede kalış ve oksijen ihtiyacı sürelerinin fizik muayene ve laboratuvar bulguları ile öngörülmesi amaçlanmıştır. Gereç ve Yöntemler: Solunum sıkıntısı nedeniyle yenidoğan yoğun bakıma yatırılan ve kliniği 24 saat içerisinde düzelmeyen geçici takipne ön tanılı hastalar çalışmaya alındı. Çıkış tanıları izole yenidoğanın geçici takipnesi olarak devam eden 60 hastanın doğumdan sonraki 4. saatlerinde ve sonrasında günlük yapılan fizik muayene ve laboratuvar bulguları ile hastanede kalış süreleri karşılaştırıldı. Hastalar yatış retraksiyon skorları ve tedavi yöntemlerine göre 4 gruba ayrıldı. Bulgular: İlk gün hesaplanan retraksiyon skoru, kan gazındaki baz fazlası değeri ve ikinci gün idrar miktarının hastaların hastanede kalış süresindeki değişimin %73’ünü; oksijen ihtiyacı süresindeki değişimin %68,7’sini açıklayabildiği bulundu. Hastanede yatış süresine ve oksijen ihtiyacına etki eden en önemli faktör ilk gün ölçülen retraksiyon skoru olarak saptandı. Ağır solunum yetmezliğinin eşlik ettiği geçici takipne açısından erkek yenidoğanlar kızlara göre 5 kat daha riskli bulundu (OR: 5,06 %95 CI: 1,1-23,3, p: 0,037). Sezaryenle doğum, prematürite ve doğum ağırlığı ağır solunum yetmezliği açısından risk faktörü olarak saptanmadı. Sonuç: Mevcut çalışma geçici takipne tanılı yenidoğanlarda retraksiyon skoru bakılmasının prognozu öngörmede yardımcı olabileceğini göstermektedir. Hastalarda idrar miktarının artışı iyileşmenin bir bulgusu olarak ele alınabilir. Geçici takipnesi olan yenidoğanlarda ağır solunum yetmezliği riski erkeklerde kızlara göre 5 kat daha fazladır

Kaynakça

  • Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child 1966;111:380-5.
  • Hein HA, Ely JW, Lofgren MA. Neonatal respiratory distress in the community hospital: when to transport, when to keep. J Fam Pract 1998;46:284-9.
  • Silverman WA, Andersen DH. A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants. Pediatrics 1956;17:1-10.
  • Escobar GJ, Shaheen SM, Breed EM, Botas C, Greene JD, Yoshida CK, et al. Richardson score predicts short-term adverse respiratory outcomes in newborns >/=34 weeks gestation. J Pediatr 2004;145:754-60.
  • Buch P, Makwana AM, Chudasama RK. Usefulness of Downe score as clinical assessment tool and bubble CPAP as primary respiratory support in neonatal respiratory distress syndrome. JPS 2013;5:e176.
  • Tollner U. Early diagnosis of septicemia in the newborn. Clinical studies and sepsis score. Eur J Pediatr 1982;138:331-7.
  • Kasap B, Duman N, Ozer E, Tatli M, Kumral A, Ozkan H. Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 2008 Feb;50:81-4.
  • Guglani L, Lakshminrusimha S, Ryan RM. Transient tachypnea of the newborn. Pediatr Rev 2008;29:e59-65.
  • Aydemir O, Aydemir C, Sarikabadayi YU, Altug N, Erdeve O, Uras N, et al. The role of plasma N-terminal pro-B-type natriuretic peptide in predicting the severity of transient tachypnea of the newborn. Early Hum Dev 2012;88:315-9.
  • Tharaux PL, Dussaule JC, Couette S, Clerici C. Evidence for functional ANP receptors in cultured alveolar type II cells. Am J Physiol 1998;274:L244-51.
  • Pesonen E, Heldt GP, Merritt TA, Sahn DJ, Elias W, Tikkanen I, et al. Atrial natriuretic factor and pulmonary status in premature infants with respiratory distress syndrome: preliminary investigation. Pediatr Pulmonol 1993;15:362-4.
  • Stroustrup A, Trasande L, Holzman IR. Randomized controlled trial of restrictive fluid management in transient tachypnea of the newborn. J Pediatr 2012;160:38-43 e1.
  • Lewis V, Whitelaw A. Furosemide for transient tachypnea of the newborn. Cochrane Database Syst Rev 2002 (1):CD003064.
  • Derbent A, Kargili A, Koca C, Gumus, II, Sevgili S, Simavli S, et al. Serum platelet-activating factor acetylhydrolase activity: relationship with metabolic syndrome in women with history of gestational diabetes mellitus. Gynecol Endocrinol 2011;27:128-33.
  • Rawlings JS, Smith FR. Transient tachypnea of the newborn. An analysis of neonatal and obstetric risk factors. Am J Dis Child 1984;138:869-71.
  • Schatz M, Zeiger RS, Hoffman CP, Saunders BS, Harden KM, Forsythe AB. Increased transient tachypnea of the newborn in infants of asthmatic mothers. Am J Dis Child 1991;145:156-8.
  • Dani C, Reali MF, Bertini G, Wiechmann L, Spagnolo A, Tangucci M, et al. Risk factors for the development of respiratory distress syndrome and transient tachypnoea in newborn infants. Italian Group of Neonatal Pneumology. Eur Respir J 1999;14:155-9.
  • Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol1995;102:101-6.
  • Riskin A, Abend-Weinger M, Riskin-Mashiah S, Kugelman A, Bader D. Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key. Am J Perinatol 2005;22:377-82.
  • Weintraub AS, Cadet CT, Perez R, DeLorenzo E, Holzman IR, Stroustrup A. Antibiotic use in newborns with transient tachypnea of the newborn. Neonatology 2013;103:235-40.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Tr
Bölüm Makaleler
Yazarlar

Mehmet Kenan Kanburoğlu Bu kişi benim

Mehmet Nevzat Çizmeci Bu kişi benim

Semra Kara Bu kişi benim

Ahmet Zülfikar Akelma Bu kişi benim

Mustafa Mansur Tatlı Bu kişi benim

Yayımlanma Tarihi 14 Aralık 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 22 Sayı: 3

Kaynak Göster

APA Kanburoğlu, M. K., Çizmeci, M. N., Kara, S., Akelma, A. Z., vd. (2015). Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores. Journal of Turgut Ozal Medical Center, 22(3), 158-164.
AMA Kanburoğlu MK, Çizmeci MN, Kara S, Akelma AZ, Mansur Tatlı M. Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores. Turgut Özal Tıp Merk Derg. Aralık 2015;22(3):158-164.
Chicago Kanburoğlu, Mehmet Kenan, Mehmet Nevzat Çizmeci, Semra Kara, Ahmet Zülfikar Akelma, ve Mustafa Mansur Tatlı. “Determining Prognosis in Neonates With Transient Tachypnea by Using Retraction Scores”. Journal of Turgut Ozal Medical Center 22, sy. 3 (Aralık 2015): 158-64.
EndNote Kanburoğlu MK, Çizmeci MN, Kara S, Akelma AZ, Mansur Tatlı M (01 Aralık 2015) Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores. Journal of Turgut Ozal Medical Center 22 3 158–164.
IEEE M. K. Kanburoğlu, M. N. Çizmeci, S. Kara, A. Z. Akelma, ve M. Mansur Tatlı, “Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores”, Turgut Özal Tıp Merk Derg, c. 22, sy. 3, ss. 158–164, 2015.
ISNAD Kanburoğlu, Mehmet Kenan vd. “Determining Prognosis in Neonates With Transient Tachypnea by Using Retraction Scores”. Journal of Turgut Ozal Medical Center 22/3 (Aralık 2015), 158-164.
JAMA Kanburoğlu MK, Çizmeci MN, Kara S, Akelma AZ, Mansur Tatlı M. Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores. Turgut Özal Tıp Merk Derg. 2015;22:158–164.
MLA Kanburoğlu, Mehmet Kenan vd. “Determining Prognosis in Neonates With Transient Tachypnea by Using Retraction Scores”. Journal of Turgut Ozal Medical Center, c. 22, sy. 3, 2015, ss. 158-64.
Vancouver Kanburoğlu MK, Çizmeci MN, Kara S, Akelma AZ, Mansur Tatlı M. Determining Prognosis in Neonates with Transient Tachypnea by Using Retraction Scores. Turgut Özal Tıp Merk Derg. 2015;22(3):158-64.