Razi Journal of Medical Sciences

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Respiratory distress syndrome is the most common cause of hospitalization in newborn that is mainly appears in the preterm infants and had revers ratio with gestational age and weight. The main cause of this disease is the surfactant dificiency that is lead to increased the alveolar surface tentionand it causes atelectasis. The cause of extent incidence of pulmonay hemorrage and infection in pathological speciamen maybe release of chemical mediators from polymorphonucloar leukocytes (PMNS) and platelets and this can cause decreased of these circulating cells. Thus, there is relationship between severity of respiratory distress syndrome (RDS) and circulating leucocytes and plateletes. The goal, of this cross-sectional study was determine of association between severity of RDS and circulation leukocyte and platelets in the first 5 day of life. For this reason, newborn that hospitalized with respiratory distress syndrome in NICU in akbarabadi hospital in 1998, have been choosen. Newborn with premature rupture of membrane, sepsis, intrauterine growth retardation, meconium aspiration or neonates that theire mothers who recived dexamethazone were omitted for effects of this agent on the circulating PMN and platlets. Thus, 66 preterm infants have been choosen and according to need to mechanical ventilation were divided to sever and mild to moderate groups. 29 infants were in sever group (43.93%) and 37 infants in mild to moderate group (56.06%). The average of the circulating platelets in first 5 days of life, in sever group was 108051.7 and in mild to moderate group was 223527, that according to statistic test. T=0.7222 and Pvalue<0.00001 that is revealed meanfull difference between two groups. The average of the leucocytes (PMNs) in first 5 days of life in sever group was between 2695.21 and 1130.13 and in mild to moderate group was between 5324.59 and 1507.72. The result of the statestic test was T=7.84289 and Pvalue<0.000001 that revealed meanful diffence in two groups. There is assosiation between severity of respiratory distress syndrome in infants and circulatory PMN and platelets.

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    The objective of the present study was to compare the incidence of RDS in preterm infants born during the first 24 hours of dexamethasone administration with those whose mothers did not receive any dexamethasone. A clinical trial study was performed on pregnant women admitted to Shahid Akbar Abadi Hospital between Sep.1999 and Sep.2000 with preterm labor at 30-36 weeks of pregnancy. In dexamethasone group, this drug was administered 5 mg every 12 hours intra muscularly, while control group did not receive dexamethasone. 100 patients who delivered during the first 24 hours of dexamethasone administration (experimental group) and 70 patients without dexamethasone administration and delivery within 24 hours of admission (control group) were selected and RDS in their neonates was compared. Also, the relationship between RDS and the route of delivery and the sex of neonates was evaluated. Based on the obtained results, in dexa group, RDS was 15% versus 27.1% in control group which was a statistically significant difference (P<0.05). In 30-31.6 weeks of pregnancy, there was 18.9% RDS in dexa group versus 35% in control group (P=0.001). In 32-33.6 weeks of pregnancy, there was 14.3% RDS in dexa group versus 30.7% in control group (P=0.001) and in 34-36 weeks of pregnancy, there was 10.7% RDS in dexa group versus 16.7% in control group which in all gestational age was statistically significant difference (P=0.004). RDS in males was more prevalent than in females (P=0.001) and neonates who were born by cesarean section suffered from RDS more than vaginally born neonates (P=0.005). According to this study, it is better to administer corticosteroids in patients who are believed that their delivery occurs less than 24 hours of drug administration.

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Background: Respiratory distress syndrome is one of the main causes of infant mortality. Surfactant is the standard treatment for it. In this study, complication of surfactant therapy via mechanical ventilation and manual injection were compared in neonates with respiratory distress syndrome admitted in neonatal intensive care unit of Besat hospital in Sanandaj.

Methods: In this retrospective cohort study, 160 infants with respiratory distress syndrome were studied. The patients included 75 patients (46.8%) in whom surfactant was administered by injection via manual ventilation and 85 patients (53.2%) in whom it was administered by mechanical ventilation. Data were entered into the software STATA-11 and t-test and chi-square was used.

Results: Of the 160 preterm neonates, 116 (69%) cases were female and 52 (31%) cases were male. The mean duration of mechanical ventilation (p=0.024) and the mean duration of oxygen therapy (p=0.018) in two groups were statistically significant. Pneumothorax rate, prevalence of Bronchopulmonar Dysplasia (BPD) and mortality rate were different between two groups but weren't statistically significant.

Conclusion: The results showed that the duration of mechanical ventilation is less in surfactant therapy with mechanical ventilation compared to manual ventilation. Considering the fewer complication of surfactant therapy with mechanical ventilation, it is recommended as a better method for surfactant administration than manual ventilation.