الفهرس 
TRANSIENT TACHYPNEA OF THE NEWBORN
Statistical methodologyOnly 14 pages are availabe for public view
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Abstract
Postnatal respiratory complications among term infants are common. The most commonly reported cause of neonatal respiratory distress is transient tachypnea of the newborn with estimated incidence of 1% to 2% of all newborns. It is thought to be caused by delayed fetal lung clearance from the pulmonary lymphatic system after birth. Although most neonates can establish effective respiration with only drying and minimal airway suction, about 10% require further intervention. Positive end expiratory pressure can be used to help aid in clearing the fetal lung fluid and maintaining the lung expansion.
The surge in postnatal natriuretic peptides is believed to have a role in transition from inta to extrauterine life by decreasing fetal lung fluid production. High levels of BNP at birth have a crucial regulatory role in the hemodynamic changes associated with extrauterine transition.
The aim of the present analysis is to test the validity of a hypothesis that introduction of early rescue CPAP via the T-piece based infant resuscitator Neopuff to neonates with RD might decrease the severity, and complications related to TTN.
The current study is a randomized interventional-follow up study that was carried out on 64 full/near term newborns with TTN delivered at Obstetrics and Gynecology department, Ghamra Military Hospital. They were randomized into 2 groups according to the management they received. The first group included 34 neonates who received early rescue CPAP treatment (Neopuff group). The second received standard care of treatment for TTN included 30 neonates (Control Group).
As regards the demographic characteristics of patients with TTN in both groups, no significant differences were found between the two studied groups regarding gestational age, sex, weight, Apgar score and the degree of RD.
On comparing the clinical outcomes in the present analysis, an evidence of clinical improvement that was reflected by reduction in the number of patients admitted to the hospital secondary to TTN, as well as reduction in the duration of respiratory distress and a decrease in the need of further mechanical support with no effect on duration of hospialization.
As regards the possible complications associated with early rescue CPAP, neither an increase in pulmonary air leaks nor mortality was noted concluding the safety of this practice.
Upon comparing the level of baseline BNP showed there were no significant differences between the Neopuff and the control group showing proper matching. 2 hours later, BNP level was accessed again and there was still no significant difference between the 2 groups showing that the Neopuff had no effect on changing the levels of BNP.
In the current analysis, a discrepancy in the levels of baseline BNP compared to its level 2 hours later was noted in the Neopuff group.
Upon comparing the serum BNP levels between Neopuff and Control groups, we noted that BNP secretion pattern in infants with TTN in the Neopuff group were similar to controls. This result was expected from previous studies done regarding this point.
On the attempts to identify various risk demarcators that predict the severity of TTN, a positive correlation between the level of BNP 2 hours after Neopuff and the duration of respiratory distress as well as the duration of hospital stay was found. By this we can conclude that higher BNP levels might be useful in predicting the severity of TTN.