Am J Perinatol 2024; 41(S 01): e109-e113
DOI: 10.1055/s-0042-1750119
Original Article

Thoracic Fluid Content in Neonates Presented with Respiratory Distress as a Predictive Tool for Transient Tachypnea of Newborn

Mohamed R. Bassiouny
1   Neonatology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
,
Shimaa E. Abdelhady
2   Neonatology Unit, Mansoura Specialized Hospital, Mansoura, Egypt
,
3   Infectious Diseases and Primary Immunodeficiency Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
› Author Affiliations

Abstract

Introduction Respiratory conditions are the most common reason for admission of newborns to a neonatal care unit. The index of contractility (ICON) can be used to measure the thoracic fluid content (TFC) in neonates which is a significant parameter in cases presented with transient tachypnea of newborn (TTN).

Objective The objective was to compare TFC between newborn infants with TTN compared with other causes of respiratory distress (RD). We tested the hypothesis that TFC would be higher in infants with TTN.

Study Design In total, 105 newborns were enrolled at the delivery room and were categorized into three groups: TTN, other causes of RD, and control, according to physical examination and Chest X-Ray. TFC was measured within the first 6 hours for all infants and at 24 and 48 hours for the first two groups.

Results Demographic data showed higher male participants and use of antenatal steroid therapy in RD groups. TFC within the first 6 hours was higher in RD groups. However, TFC at 24 hours of ≤24 mL/kg, and TFC drop rate at 24 hours of >12% are statistically significant discriminators of TTN from non-TTN, with sensitivity and specificity of 97.1 and 47.1%, and 60 and 82.4%, respectively ([Fig 1] and [2]).

Conclusion ICON can be used in conjunction with clinical parameters and CXR as a tool for differentiation between TTN and other causes of RD within the first 24 hours of life by using the cutoff value of TFC at 24 hours and TFC drop rate. This will allow earlier and optimum management of different causes of RD.

Key Points

  • Thoracic fluid content

  • Neonatal respiratory distress

  • Newborn



Publication History

Received: 22 November 2021

Accepted: 28 April 2022

Article published online:
10 July 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr Respir Rev 2013; 14 (01) 29-36 , quiz 36–37
  • 2 Shah GS, Yadav S, Thapa A, Shah L. Clinical profile and outcome of neonates admitted to neonatal intensive care unit (NICU) at a tertiary care centre in Eastern Nepal. J Nepal Paediatr 2013; 33 (03) 177-181
  • 3 Weisman LE, Hansen TN. Contemporary Diagnosis and Management of Neonatal Respiratory Diseases. 3rd ed. Newton, PA: Handbooks in Health Care Co; 2003
  • 4 Gouyon JB, Ribakovsky C, Ferdynus C, Quantin C, Sagot P, Gouyon B. Burgundy Perinatal Network. Severe respiratory disorders in term neonates. Paediatr Perinat Epidemiol 2008; 22 (01) 22-30
  • 5 Nissen MD. Congenital and neonatal pneumonia. Paediatr Respir Rev 2007; 8 (03) 195-203
  • 6 Hibbard JU, Wilkins I, Sun L. et al; Consortium on Safe Labor. Respiratory morbidity in late preterm births. JAMA 2010; 304 (04) 419-425
  • 7 Rachuri H, Oleti TP, Murki S, Subramanian S, Nethagani J. Diagnostic performance of point of care ultrasonography in identifying the etiology of respiratory distress in neonates. Indian J Pediatr 2017; 84 (04) 267-270
  • 8 Paviotti G, De Cunto A, Moressa V, Bettiol C, Demarini S. Thoracic fluid content by electric bioimpedance correlates with respiratory distress in newborns. J Perinatol 2017; 37 (09) 1024-1027
  • 9 Lotfy M, Yassen K, El Sharkawy O, Elshoney R, Moustafa A. Electrical cardiometry compared to transesophageal doppler for hemodynamics monitoring and fluid management in pediatrics undergoing Kasai operation. A randomized controlled trial. Paediatr Anaesth 2018; 6 (01) 46-54
  • 10 Sanders M, Servaas S, Slagt C. Accuracy and precision of non-invasive cardiac output monitoring by electrical cardiometry: a systematic review and meta-analysis. J Clin Monit Comput 2020; 34 (03) 433-460
  • 11 Rijal P, Shrestha M. Analysis of neonatal respiratory distress in neonatal intensive care unit at Nepal Medical College. J Nepal Health Res Counc 2018; 16 (02) 131-135
  • 12 Reuter S, Moser C, Baack M. Respiratory distress in the newborn. Pediatr Rev 2014; 35 (10) 417-428 , quiz 429
  • 13 Cleveland RH. A radiologic update on medical diseases of the newborn chest. Pediatr Radiol 1995; 25 (08) 631-637
  • 14 Kurl S, Heinonen KM, Kiekara O. The first chest radiograph in neonates exhibiting respiratory distress at birth. Clin Pediatr (Phila) 1997; 36 (05) 285-289
  • 15 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
  • 16 Abdelrahman SM, Hamed SM, Nasr A. Neonatal respiratory distress in Omdurman Maternity Hospital, Sudan. Sudan J Paediatr 2014; 14 (01) 65-70
  • 17 Anadkat JS, Kuzniewicz MW, Chaudhari BP, Cole FS, Hamvas A. Increased risk for respiratory distress among white, male, late preterm and term infants. J Perinatol 2012; 32 (10) 780-785
  • 18 Yurdakök M. Transient tachypnea of the newborn: what is new?. J Matern Fetal Neonatal Med 2010; 23 (3, Suppl 3): 24-26
  • 19 Hsu KH, Wu TW, Wang YC, Lim WH, Lee CC, Lien R. Hemodynamic reference for neonates of different age and weight: a pilot study with electrical cardiometry. J Perinatol 2016; 36 (06) 481-485
  • 20 Sumbel L, Wats A, Salameh M, Appachi E, Bhalala U. Thoracic fluid content (TFC) measurement using impedance cardiography predicts outcomes in critically ill children. Front Pediatr 2021; 8: 564902
  • 21 Zong HF, Guo G, Liu J, Bao LL, Yang CZ. Using lung ultrasound to quantitatively evaluate pulmonary water content. Pediatr Pulmonol 2020; 55 (03) 729-739
  • 22 Guo G, Zhang X-F, Liu J, Zong H-F. Lung ultrasound to quantitatively evaluate extravascular lung water content and its clinical significance. J Matern Fetal Neonatal Med 2020; 16: 1-11
  • 23 Girona-Alarcón M, Cuaresma-González A, Rodríguez-Fanjul J. et al. LUCAS (lung ultrasonography in cardiac surgery) score to monitor pulmonary edema after congenital cardiac surgery in children. J Matern Fetal Neonatal Med 2020; 35 (06) 1213-1218