Differences in Clinical Characteristics and Therapy of Neonatal Acute Respiratory Distress Syndrome (ARDS) and Respiratory Distress Syndrome (RDS): A Retrospective Analysis of 925 Cases
JingHua Luo, Jia Chen, QiuPing Li, Zhichun Feng
The Second School of Clinical Medicine, Southern Medical University, Guangzhou Guangdong, China (mainland)
Med Sci Monit 2019; 25:4992-4998
Available online: 2019-07-06
This study assessed the clinical characteristics of neonatal acute respiratory distress syndrome (ARDS) and differences in therapy in comparison to RDS.
MATERIAL AND METHODS: The clinical data of 925 preterm infants with respiratory distress were collected and divided into 4 groups. Group A and B both met the diagnosis of neonatal RDS, whereas infants in group B also showed inflammatory response. Group C met the Montreux definition of neonatal ARDS and group D was the control.
RESULTS: We found that 73.50% of the 925 preterm infants were diagnosed with RDS, of which RDS with inflammatory response accounted for 42.05%. ARDS accounted for 5.29% and control group accounted for 21.19%. Group C infants were the heaviest (2168.16±654.43 g) and had the oldest gestational age. The pregnancy-induced hypertension was highest (30.07%) in group B and lowest in group D (13.26%). Group C had higher iNO and longer invasive ventilator times, but had less frequent surfactant treatment, as well as shorter oxygen time and hospital stay. Group B had significantly longer invasive ventilator use than in Group A. In group A, PDA, ROP, and PPHN were the most common complications, with morbidity rates at 78.35%, 8.4%, and 25.77%, respectively, while group C had higher incidence of PDA (71.42%) and coagulation disorders (38.77%).
CONCLUSIONS: ARDS mainly occurs in late preterm infants. Its treatment is dependent on iNO and invasive ventilator-assisted therapy, and the surfactant treatment rate was relatively lower in comparison to RDS. RDS accompanied with inflammatory response is also dependent on prolonged use of an invasive ventilator.
Keywords: Respiratory Distress Syndrome, Adult, Respiratory Distress Syndrome, Newborn, Systemic Inflammatory Response Syndrome, Therapeutics