EVALUATION OF NEONATAL RESPIRATORY SUPPORT OUTCOMES IN LOCAL POPULATION: FROM SURFACTANT THERAPY TO HIGH-FREQUENCY VENTILATION – A RETROSPECTIVE COHORT STUDY

Authors

  • M KHAN Puran Medical Complex Khyber Pakhtunkhwa, Pakistan
  • H ALI Swat Medical Complex Swat, Pakistan
  • M AZMATULLAH Swat Medical College, Swat, Pakistan
  • N DIN CAT C Hospital, Madyan Swat, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1190

Keywords:

Respiratory Distress Syndrome, Newborn Surfactant Therapy High-Frequency Ventilation Bronchopulmonary Dysplasia Neonatal Intensive Care Units

Abstract

Neonatal respiratory distress syndrome (RDS) is a leading cause of neonatal mortality in Pakistan. Surfactant therapy and high-frequency ventilation (HFV) have been pivotal in improving survival rates. This study aims to evaluate the clinical outcomes of newborns with RDS treated with surfactant therapy and HFV in Pakistani tertiary care centres. Objective: To assess the impact of surfactant therapy and HFV on neonatal mortality, incidence of bronchopulmonary dysplasia (BPD), length of NICU stay, and overall survival rates in neonates with RDS. Methods: A retrospective cohort study was conducted at Swat Medical College, Swat, Pakistan in the duration from October 2023 to March 2024. Data were collected on neonates diagnosed with RDS, with two treatment groups: those receiving surfactant therapy only (Group A) and those receiving surfactant therapy with high-frequency ventilation (Group B). Statistical analysis was conducted using SPSS 25.0, comparing mortality rates, BPD incidence, and length of NICU stay between the two groups. Results: Among 300 neonates included in the study, Group A (n=150) had a neonatal mortality rate of 25%, while Group B (n=150) had a mortality rate of 15% (p=0.02). The incidence of BPD was significantly lower in Group B (18%) compared to Group A (30%) (p=0.03). The median length of NICU stay was 20 days for Group A and 15 days for Group B (p=0.01). Neonates receiving HFV had better overall survival outcomes. Conclusion: The use of HFV, combined with surfactant therapy, significantly improves survival outcomes and reduces BPD incidence and NICU stay duration in neonates with RDS.

Downloads

Download data is not yet available.

References

Bacha LT, Hailu WB, Tesfaye Geta EJSOM. Clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College. 2022;10:20503121221146068.

Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A, et al. European consensus guidelines on the management of respiratory distress syndrome–2019 update. 2019;115(4):432-50.

Rafiq K, Islam MR, Siddiky NA, Samad MA, Chowdhury S, Hossain KM, et al. Antimicrobial resistance profile of common foodborne pathogens recovered from livestock and poultry in Bangladesh. 2022;11(11):1551.

Kollisch-Singule M, Ramcharran H, Satalin J, Blair S, Gatto LA, Andrews PL, et al. Mechanical ventilation in pediatric and neonatal patients. 2022;12:805620.

Keszler M, Durand DJJCip. Neonatal high-frequency ventilation: past, present, and future. 2001;28(3):579-607.

Lin J, Deng H, Zhang Y, Zou L, Fu Z, Dai JJPp. Effect of human umbilical cord‐derived mesenchymal stem cells on murine model of bronchiolitis obliterans like injury. 2021;56(1):129-37.

Holmes A, Chen Z, Yahng L, Fletcher D, Kawata KJFip. Return to learn: academic effects of concussion in high school and college student-athletes. 2020;8:57.

Ekhaguere OA, Okonkwo IR, Batra M, Hedstrom ABJFip. Respiratory distress syndrome management in resource limited settings—Current evidence and opportunities in 2022. 2022;10:961509.

Archana D. Study of Early Neonatal Morbidities and Maternal Risk Factors Involved in Late Preterms Born in Rarjarajeswari Hospital: Rajiv Gandhi University of Health Sciences (India); 2019.

Ozer EAJJoCN. Lung-protective ventilation in neonatal intensive care unit. 2020;9(1):1-7.

Ackermann BW, Klotz D, Hentschel R, Thome UH, van Kaam AHJPr. High-frequency ventilation in preterm infants and neonates. 2023;93(7):1810-8.

Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. 2011;8(8):e1001080.

Fischer HS, Buehrer CJP. Avoiding endotracheal ventilation to prevent bronchopulmonary dysplasia: a meta-analysis. 2013;132(5):e1351-e60.

Springer JE, Elkheir S, Eskicioglu C, Doumouras AG, Kelly S, Yang I, et al. The effect of simethicone on postoperative ileus in patients undergoing colorectal surgery (SPOT), a randomized controlled trial. 2018;56:141-7.

Luo H, Lu J, Bai Y, Mao T, Wang J, Fan Q, et al. Effect of camrelizumab vs placebo added to chemotherapy on survival and progression-free survival in patients with advanced or metastatic esophageal squamous cell carcinoma: the ESCORT-1st randomized clinical trial. 2021;326(10):916-25.

Rattani SA. Case study describing access to palliative care in Pakistan. 2020.

Langan SM, Schmidt SA, Wing K, Ehrenstein V, Nicholls SG, Filion KB, et al. The reporting of studies conducted using observational routinely collected health data statement for pharmacoepidemiology (RECORD-PE). 2018;363.

Pande T, Huddart S, Xavier W, Kulavalli S, Chen T, Pai M, et al. Prevalence of diabetes mellitus amongst hospitalized tuberculosis patients at an Indian tertiary care center: a descriptive analysis. 2018;13(7):e0200838.

Downloads

Published

2024-10-15

How to Cite

KHAN , M., ALI , H., AZMATULLAH , M., & DIN , N. (2024). EVALUATION OF NEONATAL RESPIRATORY SUPPORT OUTCOMES IN LOCAL POPULATION: FROM SURFACTANT THERAPY TO HIGH-FREQUENCY VENTILATION – A RETROSPECTIVE COHORT STUDY. Biological and Clinical Sciences Research Journal, 2024(1), 1190. https://doi.org/10.54112/bcsrj.v2024i1.1190

Most read articles by the same author(s)

1 2 > >>