The Pattern of Diagnosis in NICU Population Presenting With Respiratory Distress

Article Information

Title: The Pattern of Diagnosis in NICU Population Presenting With Respiratory Distress

Authors: Hakeem Ullah, Asad Maqbol, Asma Razzaq, Romisa Rehman, Ihsan Ullah, Muhammad awais

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 2

Language: English

DOI: 10.51253/pafmj.v72i2.7352

Keywords: CausesOutcomeNeonatesRespiratory distress

Abstract

Objective: To evaluate the etiology, frequency, and results of respiratory distress in newborns in the intensive care unit.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital (CMH) in Peshawar, from Aug 2020 to May 2021
Methodology: It included neonates admitted to the Neonatal Intensive Care Unit between the ages of 0 and 28 days
Results: The study included 182 neonates, 107 (58.6%) of whom were boys and 75 (41.4%) were girls. The average age was 68.47 ± 98.60 hours, the average gestational age was 32.6 ± 23.52 weeks, and the average weight was 2.50 ± 2.6 kg. All (100%) of the neonates had a respiratory rate &gt;60 breaths per minute. Regarding symptoms and signs, 110 (60%) reported grunting, 182 (100%) reported nasal flaring and subcostal retractions, and 72 (40%) reported cyanosis. Respiratory distress syndrome, meconium aspiration syndrome, pneumonia, transient tachypnea of the newborn, sepsis, and birth asphyxia was observed in 42 (22.8%), 30 (16.6%), 32 (17.6%), 26 (14.1%), 32 (18.04%), and 20 (10.8%) newborns, respectively. The number of 60 (33.2%) neonates were suffering from respiratory distress.
Conclusion: High frequency of respiratory distress among the neonates was observed along with high rates of mortality in those having respiratory distress, especially in low birth weight and pre-term neonates.

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Research Objective

To evaluate the etiology, frequency, and results of respiratory distress in newborns in the intensive care unit.

Methodology

Descriptive cross-sectional study conducted in the Neonatal Intensive Care Unit, CMH Peshawar, from August 2020 to May 2021. The study included 182 neonates aged 0-28 days, with a gestational age greater than 28 weeks and weight greater than 1000 gm. Neonates with postoperative respiratory distress, congenital anomalies, and syndromes were excluded. Data was analyzed using SPSS version 20.

Methodology Flowchart

                        graph TD;
    A["Recruit Neonates 0-28 days"] --> B["Examine and Obtain Consent"];
    B --> C["Assess for Respiratory Distress Symptoms"];
    C --> D["Diagnose Specific Causes RDS, MAS, Pneumonia, TTN, Sepsis, Birth Asphyxia"];
    D --> E["Record Data Demographics, Symptoms, Diagnoses, Outcomes"];
    E --> F["Data Analysis SPSS v20"];
    F --> G["Interpret Results and Draw Conclusions"];

Discussion

Pneumonia and sepsis were identified as the most common causes of respiratory distress in newborns in this study. The study highlights that newborns with respiratory distress are significantly more prone to mortality. The findings suggest that adequate hospital facilities may contribute to differences in outcomes compared to developing countries. The study also notes that a significant portion of morbidity and mortality occurred in newborns with low birth weight and low gestational age.

Key Findings

The study included 182 neonates, with 58.6% being boys. The average gestational age was 32.6 weeks and average weight was 2.50 kg. All neonates (100%) had a respiratory rate >60 breaths per minute. Common symptoms included grunting (60%), nasal flaring (100%), subcostal retractions (100%), and cyanosis (40%). The most frequent diagnoses were Respiratory Distress Syndrome (22.8%), Sepsis (18.04%), Pneumonia (17.6%), and Meconium Aspiration Syndrome (16.6%). Overall, 33.2% of neonates suffered from respiratory distress.

Conclusion

Sepsis, Transient Tachypnea of the Newborn (TTN), birth asphyxia, Meconium Aspiration Syndrome (MAS), pneumonia, and Respiratory Distress Syndrome (RDS) were the most common causes of respiratory distress. RDS was the leading cause of death, often linked to preterm birth and low birth weight, which can lead to sepsis. Further individual studies on other causes are recommended for better understanding of management and outcomes.

Fact Check

1. Number of neonates: The study included 182 neonates. This is stated in the abstract and results section.
2. Percentage of boys: 58.6% of the neonates were boys. This is stated in the abstract and results section.
3. Respiratory rate: 100% of the neonates had a respiratory rate >60 breaths per minute. This is stated in the abstract and results section.

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