Comparative Study on the Clinical Characteristics of Transient Tachypnea of Newborns according to the Need for Invasive Mechanical Ventilation
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Purpose: Transient tachypnea of the newborn (TTN) is the most prevalent respiratory disease worldwide. Many neonates with TTN generally demonstrate spontaneous improvement. However, only few patients present with severe complications. This study aimed to investigate the differences in clinical features to identify neonates at risk for further complications. Methods: Between January 2015 and December 2020, 267 neonates who developed dyspnea within 6 h of birth were delivered at a gestational age of at least 37 weeks. The experimental group (group E) included 44 neonates who required invasive mechanical ventilation, whereas the control group (group C) included 223 neonates who required only observation or non-invasive respiratory support. We analyzed the differences in clinical and perinatal factors between the two groups. Results: Gestational age and pH on arterial blood gas analysis at admission were significantly lower in group E (P<0.05). Clinical findings, such as moaning, tachypnea (>90 breaths/min), and pneumothorax, were more frequently observed in group E (P<0.05). Conclusion: Moaning, tachypnea (>90 breaths/min), and need for respiratory assistance (fraction of inspired oxygen concentration ≥0.25) are predictive factors for increased risk of progression to a more severe disease course in neonates with TTN. Additional studies are needed to identify definitive factors that can differentiate TTN that improves spontaneously from TTN that requires intensive care.
Abstract
Purpose: Transient tachypnea of the newborn (TTN) is the most prevalent respiratory disease worldwide. Many neonates with TTN generally demonstrate spontaneous improvement. However, only few patients present with severe complications. This study aimed to investigate the differences in clinical features to identify neonates at risk for further complications. Methods: Between January 2015 and December 2020, 267 neonates who developed dyspnea within 6 h of birth were delivered at a gestational age of at least 37 weeks. The experimental group (group E) included 44 neonates who required invasive mechanical ventilation, whereas the control group (group C) included 223 neonates who required only observation or non-invasive respiratory support. We analyzed the differences in clinical and perinatal factors between the two groups. Results: Gestational age and pH on arterial blood gas analysis at admission were significantly lower in group E (P<0.05). Clinical findings, such as moaning, tachypnea (>90 breaths/min), and pneumothorax, were more frequently observed in group E (P<0.05). Conclusion: Moaning, tachypnea (>90 breaths/min), and need for respiratory assistance (fraction of inspired oxygen concentration ≥0.25) are predictive factors for increased risk of progression to a more severe disease course in neonates with TTN. Additional studies are needed to identify definitive factors that can differentiate TTN that improves spontaneously from TTN that requires intensive care.
참고문헌 (21)
- Tutdibi E, "Impact of labor on outcomes in transient tachypnea of the newborn : population-based study", Pediatrics, 125, pp.e577~e583 (2010)
- Avery ME, "Transient tachypnea of newborn : possible delayed resorption of fluid at birth", Am J Dis Child, 111, pp.380~385 (1966)
- Yurdakok M, "Transient tachypnea of the newborn : what is new?", J Matern Fetal Neonatal Med, 23(Suppl 3), pp.24~26 (2010)
- Osman AM, "Early rescue neopuff for infants with transient tachypnea of newborn : a randomized controlled trial", J Matern Fetal Neonatal Med, 32, pp.597~603 (2019)
- Ozalkaya E, "Risk factors in retained fetal lung fluid syndrome", J Neonatal Perinatal Med, 8, pp.85~89 (2015)
- Kurl S, "The first chest radiograph in neonates exhibiting respiratory distress at birth", Clin Pediatr(Phila), 36, pp.285~289 (1997)
- Foglia EE, "Neonatal intubation practice and outcomes : an international registry study", Pediatrics, 143, pp.e20180902~ (2019)
- Ramachandrappa A, "Morbidity and mortality in late preterm infants with severe hypoxic respiratory failure on extra-corporeal membrane oxygenation", J Pediatr, 159, pp.192~198 (2011)
- Hansen AK, "Risk of respiratory morbidity in term infants delivered by elective caesarean section : cohort study", BMJ, 336, pp.85~87 (2008)
- Pirjani R, "Elective caesarean section at 38-39 weeks gestation compared to > 39 weeks on neonatal outcomes : a prospective cohort study", BMC Pregnancy Childbirth, 18, pp.140~ (2018)
- Menacker F, "Cesarean delivery:background, trends, and epidemiology", Semin Perinatol, 30, pp.235~241 (2006)
- Onal EE, "Serum atrial natriuretic peptide levels in infants with transient tachypnea of the newborn", J Matern Fetal Neonatal Med, 17, pp.145~149 (2005)
- Alhassen Z, "Recent advances in pathophysiology and management of transient tachypnea of newborn", J Perinatol, 41, pp.6~16 (2021)
- Celebi MY, "Impact of prophylactic continuous positive airway pressure on transient tachypnea of the newborn and neonatal intensive care admission in newborns delivered by elective cesarean section", Am J Perinatol, 33, pp.99~106 (2016)
- Elfarargy MS, "Therapeutic effect of inhaled budesonide in transient tachypnea of newborn : a placebo-controlled study", J Popul Ther Clin Pharmacol, 27, pp.e78~e86 (2020)
- Wettstein RB, "Delivered oxygen concentrations using low-flow and high-flow nasal cannulas", Respir Care, 50, pp.604~609 (2005)
- Zanardo V, "Neonatal respiratory morbidity risk and mode of delivery at term : influence of timing of elective caesarean delivery", Acta Paediatr, 93, pp.643~647 (2004)
- Lakshminrusimha S, "Persistent pulmonary hypertension of the newborn", Neoreviews, 16, pp.e680~e692 (2015)
- Kasap B, "Transient tachypnea of the newborn : predictive factor for prolonged tachypnea", Pediatr Int, 50, pp.81~84 (2008)
- Atasay B, "The association between cord hormones and transient tachypnea of newborn in late preterm and term neonates who were delivered by cesarean section", J Matern Fetal Neonatal Med, 26, pp.877~880 (2013)
- Hirata K, "Impact of time to neonatal transport on outcomes of transient tachypnea of the newborn", Am J Perinatol, 36, pp.1090~1096 (2019)