Respiratory Distress Syndrome, Newborn
Conditions
Brief summary
This work is designed to: 1. Evaluate the efficacy of lung ultrasonography in detecting opening and closing lung pressures in ventilated preterm neonates with respiratory distress syndrome. 2. Determine the efficacy of lung ultrasonography in optimizing lung volume and its correlation with pulmonary inflammatory reaction as evidenced by IL-6 level in tracheal aspirate.
Detailed description
The studied population included 44 preterm infants. Anthropometric measurements, gestational age, sex, mode of delivery, maternal disease and Apgar score were found to be matched in the two studied groups indicating successful randomization as seen in these balanced demographic variables between the groups. The studied population included 44 preterm infants. Then they were allocated randomly to one of 2 groups in order by admission: Group A: included 22 patients on whom the recruitment maneuver was applied guided by lung ultrasonography. Group B: included 22 patients on whom the recruitment maneuver was not ultrasound guided. This is considered the control group. Anthropometric measurements, gestational age, sex, mode of delivery, maternal disease and Apgar score were found to be matched in the two studied groups indicating successful randomization as seen in these balanced demographic variables between the groups.
Interventions
Lung recruitment maneuver done for ventilated preterm neonates diagnosed with respiratory distress syndrome
OTHERtracheal IL-6 level
tracheal IL-6 level was measured before and after recruitment maneuver
OTHERUS guided lung recruitment maneuver
Lung recruitment maneuver done for ventilated preterm neonates diagnosed with respiratory distress syndrome guided by lung ultrasound
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
The study was conducted on 44 preterm neonates who were mechanically ventilated for respiratory distress syndrome (RDS). Then they were allocated randomly to one of 2 groups in order by admission: Group A: it included 22 patients on whom the recruitment manoeuvre was applied guided by lung ultrasonography. Group B: it included 22 patients on whom the recruitment maneuver was not ultrasound guided. This is considered the control group.
Eligibility
Sex/Gender
ALL
Age
1 Hours to 2 Days
Healthy volunteers
No
Inclusion criteria
1. Gestational age ≤ 36 weeks. 2. In need for invasive mechanical ventilation for RDS according to Downes Score .
Exclusion criteria
* excluded: 1. Major upper or lower airway anomalies. 2. Significant congenital anomalies including cardiac, abdominal or respiratory. 3. Surgical cases 4. Inborn errors of metabolism 5. Early onset sepsis. 6. Meconium aspiration syndrome. 7. Hypoxic ischemic encephalopathy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lung ultrasound and diagnosis of respiratory distress syndrome | 1 year | Forty four preterm neonates diagnosed with respiratoey distress syndrome had lung ultrasound assessment . Its grading was N=normal (presence of lung sliding with A lines or fewer than two isolated B lines) , B1=multiple well-defined B lines , B2=multiple coalescent B lines , C=Consolidation. |
| Lung ultrasound and recruitment maneuver | 1 year | An ultrasound re aeration score is calculated from changes in the ultrasound pattern of each region examined during the recruitment maneuver (N,B1,B2,C). |
| Lung ultrasound guided recruitment maneuver and the period of oxygen dependency. | 1 year | The relation between early lung recruitment maneuver guided by lung ultrasound and how many days requiring oxygen therapy in the NICU . |
| Lung ultrasound guided recruitment maneuver and the total number of NICU admission days. | 1 year | The relation between early lung recruitment maneuver guided by lung ultrasound and how many days requiring admission in the NICU . |
| Lung ultrasound guided recruitment maneuver and its relation to lung inflammation | 1 year | Tracheal aspirate IL-6 is measured initially before recruitment maneuver, and on the third day if still ventilated ,or before extubation if done earlier than the third day. |
Countries
Egypt
Outcome results
None listed