STUDY OF DIFFERENT TREATMENT MODALITIES AND OUTCOME IN PRETERM BABIES WITH RESPIRATORY DISTRESS SYNDROME
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 72
Abstract
BACKGROUND Hyaline membrane disease (HMD) is the commonest cause of respiratory distress among preterm newborn babies. The term HMD is often used synonymously with RDS. The current incidence of HMD in our country is 10 - 15/1000 live births and in preterm babies is 10% - 15%2. The primary cause of RDS is inadequate pulmonary surfactant. The manifestations of the disease are caused by the consequent diffuse alveolar atelectasis, oedema and cell injury. MATERIALS AND METHODS It is a prospective, observational study of respiratory distress syndrome in preterm babies admitted in NICU at tertiary care hospital from November 2013 to November 2015. Total 150 babies as per the inclusion and exclusion criteria were included in the study. Detailed history and clinical findings were collected in the predesigned proforma. This data was further analysed using descriptive statistics. The statistical software namely SPSS 21, Chi-square test was used for the analysis of the data and Microsoft Word and Excel have been used to generate graphs and tables, etc. RESULTS It was found that majority of babies were 32 - 34 weeks of gestation. Of the 146 babies who received antenatal steroids, 117 survived and 29 died. While all 4 who did not receive antenatal steroids died. Surfactant was given to 86 babies, of which 76 babies received within 10 hrs. Out of 63 babies who did not receive surfactant, 41 survived and 23 died. Amongst the 41 babies who received only CPAP as treatment, all survived. Out of the 76 babies who received Surfactant within 10 hrs. and CPAP, 75 survived and 1 died; 10 babies who received surfactant after 10 hrs. and ventilator care only 2 survived and 8 died. Amongst 23 babies who only received ventilator care, all died. The co-morbidities in the form of IVH, PDA, pulmonary haemorrhage, pneumothorax, neonatal sepsis and NEC were seen in 54% of babies. Neonatal sepsis was seen in 14.6% of babies. CONCLUSION DS was more common in babies with 32 - 34 weeks gestation. Antenatal steroids and surfactant definitely improved the survival rate in preterm babies with RDS. CPAP is simple and effective means of primary respiratory support for management of mild grade RDS. Early administration of surfactant reduced the need for ventilator care and also the mortality. Neonatal sepsis was the commonest comorbidity associated.
Authors and Affiliations
Deepa Sachin Phirke, Sudhakar Bantewad, Swati Khot
Keywords
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- EP ID EP265555
- DOI 10.14260/jemds/2017/1111
- Views 78
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