Respiratory strategies affecting the severity of neonatal transient tachypnea

DOI: https://doi.org/10.29296/25877305-2022-01-09
Issue: 
1
Year: 
2022

E. Shestak(1); Professor O. Kovtun(2), Corresponding Member of the Academy of Medical Sciences,
MD; O. Ksenofontova(1), Candidate of Medical Sciences; D. Dodrov(1); N. Kalyakova(1) (1)Yekaterinburg
Clinical Perinatal Center (2)Ural State Medical University of the Ministry of Health of the Russia

Introduction: Transient tachypnea of the newborn (TNT) is a parenchymal lung disease characterized by pulmonary edema and is a common cause of respiratory distress in the first hours of life. Diagnosis and treatment of TTN consists in timely detection of respiratory disorders, determination of their severity and selection of the appropriate method of respiratory strategy, which allows avoiding hospitalization in the neonatal intensive care unit (NICU) and severe complications. Objective of the study: to analyze the respiratory strategy of patients with TTN, which determines the severity of the course of the disease, and to identify among patients a risk group for the formation of the most severe variant of the course of the disease. Methods: Retrospective analysis of full-term newborns of the Yekaterinburg Clinical Perinatal Center in 2020 with a diagnosis of TTN (n=201). A comparative analysis of 3 groups of patients, allocated in accordance with the routing from the delivery room, was carried out. Results: Our study made it possible to highlight the group of patients admitted to the ICU not from the delivery room, but from the neonatal department. These infants showed the most severe course of TTN and the longest hospital stay among all the studied groups. Also, significant differences between the groups were found in the assessment of the severity of respiratory failure and the tactics of respiratory strategy in the delivery room and the neonatal department. Conclusions: The results of the study proved the following: 1. full-term patients with TTN hospitalized from the neonatal department in the ICU show the most severe course of the disease; 2. An assessment of respiratory failure of 3 points on the Downs scale at the stage of the delivery room is a sign of an unfavorable course of TTN and a high probability of hospitalization in the ICU; 3. The severity of the condition of patients with TTN is directly affected by the absence of CPAP in the delivery room and the duration of therapy with high-flow cannulas in the neonatal department.

Keywords: 
neonatology
transient tachypnea of newborns
full-term newborn
respiratory failure
delivery room
CPAP
neonatal intensive care unit



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