Reaction of term newborns with prolonged postnatal dyspnoea to early oxygen, mask continuous positive airway pressure, and volume expansion: A ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1996-09

AUTHORS

A. C. Hauer, H. Rosegger, J. Haas, E. Q. Haxhija

ABSTRACT

In a prospective, randomised, open trial 103 term newborns with persisting dyspnoea, tachypnoea and/or cyanosis were treated with oxygen for 5–10 min and then with oxygen plus mask continuous positive airway pressure (CPAP) for another 5–15 min. Cases with overt prenatal or intrapartum obstetric pathology had been excluded from the study. Forty-one infants (40%) responded to this procedure within 10–25 min. The remaining 62 infants (60%) were randomly allocated to one of three forms of further treatment: continuation of mask CPAP for 20 min (group A,n=24), volume expansion with 9 ml of 3 ml albumin, 3 ml glucose, and 3 mEq of sodium bicarbonate (group B,n=24), or volume expansion with 4.5 ml albumin and 4.5 ml glucose (group C,n=14). There was no statistical difference in birth weight, gestational age or Apgar scores at 1 and 5 min between the infants of the groups. Time to normalisation of symptoms was significantly shorter in the volume expansion groups (B: 45±41 min, range 20–180, and C: 80±72 min, range 20–210) than in the mask CPAP group (A: 224±256 min, range 30–1200,P=0.02). There were statistical differences in umbilical cord and capillary pH values among the infants of the three groups, but the response to therapy was not related to the degree of acidaemia. Thirty-four infants (33%) who did not respond were admitted to a special care unit for further examination (group A: 21/24, group B: 7/24; group C: 6/14). Of these, 23 had no abnormal findings, 8 infants had radiological signs of transitory respiratory distress, and 1 had a nontension pneumothorax. Septicaemia was found in two infants. No infant was intubated. At discharge all 103 infants did well.ConclusionIncremental application of simple primary care procedures including volume expansion (with or without alkali) in term newborns with persisting postnatal tachypnoea and dyspnoea helps avoid overtreatment and unnecessary separation from the mothers in most cases and reliably selects infants who need close monitoring or special treatment. More... »

PAGES

805-810

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf02002912

DOI

http://dx.doi.org/10.1007/bf02002912

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1026114565

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/8874117


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