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Management of Neonatal Respiratory Distress Syndrome Employing ACoRN Respiratory Sequence Protocol versus Early Nasal Continuous Positive Airway Pressure Protocol.

Niknafs P, Faghani A, Afjeh SA, Moradinazer M, Bahman-Bijari B - Iran J Pediatr (2014)

Bottom Line: The ratios of BPD of group I to group II and PH of group I to group two were not significant (P=0.63 and P=0.84, respectively).According to the findings the incidence of air leak, grade III and IV IVH and MR was less common in E-NCPAP protocol, so it may show the effectiveness of this protocol.The authors suggest that more researches are needed for more accurate results.

View Article: PubMed Central - PubMed

Affiliation: Afzalipour Medical Center.

ABSTRACT

Objective: Respiratory distress syndrome (RDS) is a common cause of respiratory distress in premature infants. This study was designed to evaluate two different RDS treatment protocols by comparing the outcomes.

Methods: This study was a double center cross sectional study performed from June to December 2012. During that period, 386 neonates with RDS were hospitalized and treated according to two different therapeutic protocols so-called Acute Care of at-Risk Newborns (ACoRN) respiratory sequence protocol (group I) and Early Nasal Continuous Positive Airway Pressure (E-NCPAP) protocol (group II). The variables and main outcomes of this study were gestational age, birth weight, bronchopulmonary dysplasia (BPD), pulmonary hemorrhage (PH), intraventricular hemorrhage (IVH), air leak and mortality rate (MR). Findings : Out of 386 infants, 202 infants were in group I (male 60.4%, female 39.6%, mean gestational age 31(6/7) weeks, mean birth weight=1688 grams) and group II included 184 infants (male 61.4%, female 38.6%, mean gestational age 32 weeks, mean birth weight 1787 grams), P= 0.07. The ratios of BPD of group I to group II and PH of group I to group two were not significant (P=0.63 and P=0.84, respectively). Air leak ratio in group I was higher than in group II (P=0.001). Although IVH ratio in group II was higher than in group I (P=0.01), grade III and IV IVH was higher in group I (30% vs. 4.6%). In case of MR, it was higher in group I than in group II (P=0.001).

Conclusion: According to the findings the incidence of air leak, grade III and IV IVH and MR was less common in E-NCPAP protocol, so it may show the effectiveness of this protocol. The authors suggest that more researches are needed for more accurate results.

No MeSH data available.


Related in: MedlinePlus

Early-NCPAP protocol approach (group II).
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Figure 1: Early-NCPAP protocol approach (group II).

Mentions: In data collection phase of group I a total of 253 inborn neonates with respiratory distress were admitted to NICU but because of excluding factors, only 202 patients were included in this group. The second protocol was Early Nasal Continuous Positive Airway Pressure protocol (group II), which was conducted in Mahdieh Medical Center in Tehran affiliated with Shahid Beheshti University of Medical Sciences. The NICU of Mahdieh Medical Center has 33 level III and 15 level II beds. In that protocol, neonates admitted with RDS were divided in two groups based on their birth weight: >1500 grams and ≤1500 grams, and were treated and received respiratory supports according to Fig 1[7]. During the study period, 258 inborn neonates with respiratory distress were admitted to group II NICU but because of excluding factors, only 184 cases were included in this group.


Management of Neonatal Respiratory Distress Syndrome Employing ACoRN Respiratory Sequence Protocol versus Early Nasal Continuous Positive Airway Pressure Protocol.

Niknafs P, Faghani A, Afjeh SA, Moradinazer M, Bahman-Bijari B - Iran J Pediatr (2014)

Early-NCPAP protocol approach (group II).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359605&req=5

Figure 1: Early-NCPAP protocol approach (group II).
Mentions: In data collection phase of group I a total of 253 inborn neonates with respiratory distress were admitted to NICU but because of excluding factors, only 202 patients were included in this group. The second protocol was Early Nasal Continuous Positive Airway Pressure protocol (group II), which was conducted in Mahdieh Medical Center in Tehran affiliated with Shahid Beheshti University of Medical Sciences. The NICU of Mahdieh Medical Center has 33 level III and 15 level II beds. In that protocol, neonates admitted with RDS were divided in two groups based on their birth weight: >1500 grams and ≤1500 grams, and were treated and received respiratory supports according to Fig 1[7]. During the study period, 258 inborn neonates with respiratory distress were admitted to group II NICU but because of excluding factors, only 184 cases were included in this group.

Bottom Line: The ratios of BPD of group I to group II and PH of group I to group two were not significant (P=0.63 and P=0.84, respectively).According to the findings the incidence of air leak, grade III and IV IVH and MR was less common in E-NCPAP protocol, so it may show the effectiveness of this protocol.The authors suggest that more researches are needed for more accurate results.

View Article: PubMed Central - PubMed

Affiliation: Afzalipour Medical Center.

ABSTRACT

Objective: Respiratory distress syndrome (RDS) is a common cause of respiratory distress in premature infants. This study was designed to evaluate two different RDS treatment protocols by comparing the outcomes.

Methods: This study was a double center cross sectional study performed from June to December 2012. During that period, 386 neonates with RDS were hospitalized and treated according to two different therapeutic protocols so-called Acute Care of at-Risk Newborns (ACoRN) respiratory sequence protocol (group I) and Early Nasal Continuous Positive Airway Pressure (E-NCPAP) protocol (group II). The variables and main outcomes of this study were gestational age, birth weight, bronchopulmonary dysplasia (BPD), pulmonary hemorrhage (PH), intraventricular hemorrhage (IVH), air leak and mortality rate (MR). Findings : Out of 386 infants, 202 infants were in group I (male 60.4%, female 39.6%, mean gestational age 31(6/7) weeks, mean birth weight=1688 grams) and group II included 184 infants (male 61.4%, female 38.6%, mean gestational age 32 weeks, mean birth weight 1787 grams), P= 0.07. The ratios of BPD of group I to group II and PH of group I to group two were not significant (P=0.63 and P=0.84, respectively). Air leak ratio in group I was higher than in group II (P=0.001). Although IVH ratio in group II was higher than in group I (P=0.01), grade III and IV IVH was higher in group I (30% vs. 4.6%). In case of MR, it was higher in group I than in group II (P=0.001).

Conclusion: According to the findings the incidence of air leak, grade III and IV IVH and MR was less common in E-NCPAP protocol, so it may show the effectiveness of this protocol. The authors suggest that more researches are needed for more accurate results.

No MeSH data available.


Related in: MedlinePlus