GULHANE MEDICAL JOURNAL 2005 , Vol 47 , Issue 4
Retrospective evaluation of low birth weight newborns followed up with the diagnosis of respiratory distress syndrome in the newborn intensive care unit
Mustafa Kul1, Mehmet Saldır2, Mustafa Gülgün2, Vural Kesik2, S.Ümit Sarıcı1, Faruk Alpay1
1GATA Neonatoloji BD.
2GATA Çocuk Sağlığı ve Hastalıkları AD.
The objective of this study is to evaluate the demographic features, treatments given, and the early and late neonatal problems in the low birthweight infants followed up and treated with the diagnosis of respiratory distress syndrome in our intensive care unit between January 2003 and December 2004. The demographic features, treatments given (mechanical ventilation, surfactant), causes of mortality, and the early neonatal problems such as sepsis, necrotizing enterocolitis, pneumothorax, ventilatory associated pneumonia, intracranial hemorrhage and patent ductus arteriosus, and the late ones such as chronic lung disease, periventricular leukomalacia, retinopathy of prematurity were recorded retrospectively. Of the 49 newborns included in the study, 35 (71.4%) were male, and 14 (28.6%) were female. Thirty five (71.4%) infants were born by cesarian section and, 14 (28.6%) were born by vaginal delivery. The mean birth weight was 1493±456 g (780-2320 g), and the mean gestational period was 30.0±2.5 (25-36) weeks. Respiratory distress syndrome was evaluated as severe, intermediate, and mild in 5 (10.2%), 12 (24.5%), and 32 (65.3%) cases, respectively. At least one dose of surfactant was given in 85.7% of the newborns. Bronchopulmonary dysplasia (36.7%), retinopathy of prematurity (16.3%), periventricular leukomalacia (10.2%), and stage III-IV intracranial hemorrhage (6.1%) were the most common reasons of morbidity. Indomethacin or ibuprofen therapy was given in seven patients (14.3%) because of patent ductus arteriosus. The overall mortality rate was 6.1%. Although the mortality rate due to respiratory distress syndrome is not high in our unit, late neonatal problems associated with respiratory distress syndrome such as bronchopulmonary dysplasia are relatively frequent. It is assumed, therefore, that prevention of prematurity by means of sufficient and systematic perinatal follow up, and application of less aggresive mechanic ventilation and treatment procedures will decrease the morbidity associated with respiratory distress syndrome. Keywords : Prematurity, respiratory distress syndrome, surfactant, newborn