34 Risk Factors Associated with Respiratory Distress (RD) in Term Neonates with and Without Air Leak: A Case Controlled Quality Assurance Study
Notice bibliographique
Résumé
Perinatal and neonatal risk factors associated with air leak syndrome in term neonates (≥37 wk) have not been extensively studied. Furthermore, it has been difficult to differentiate air leak syndromes from other respiratory problems on clinical presentation and examination. We sought to investigate this issue with a view to identifying risk factors specific to air leak syndromes. During a two year period (January 2000 to December 2002) neonatal and maternal case records of inborn infants presenting with respiratory distress and air leak were reviewed. These infants were matched with another group of infants with similar presentation without air leak using parameters of birthweight (gms), gender and gestational age (wks). Maternal data included age, parity, type and duration of delivery, pregnancy and labor complications, nature of induction and presence of meconium in amniotic fluid. Infant data collected were: attendance of NICU staff at delivery, need for and description of resuscitation, the type of air leak, need for mechanical ventilation, use of tracheal toilet and direct admission to the NICU from the labor suite Vs later admission from the newborn nursery. The burden of illness was assessed using length of stay in the NICU, number of x-rays performed and number of doses of antibiotics administered. Statistical analysis was carried out using parametric and non-parametric T test where applicable. A value of P<.05 was used for significance. The data below is presented in two groups, those with air leak and those without using Mean ± 2 S.D. There was 27 infants in each group. The following maternal characteristics were significantly different, length of rupture of membranes 1158±60 min Vs 879± 55 min (P<.01), length of first stage of labor 694±45 min Vs 472±35 min (P<.01) and length of second stage of labor 95±10 min Vs 73±13 min (P<.05). All other maternal data among the two groups were similar. 2 infants in the air leak group required needle aspiration, a single infant was mechanically ventilated, and 2 infants required the insertion of chest drains. There were 13 infants with right pneumothoraces, 11 with left pneumothoraces, 3 with bilateral air leaks and 2 infants with mediastinal air. The average number of chest x-rays in the air leak group was 3.2±1 Vs 1±0.2 in the RD group without air leak (P<.001). The average length of stay in the NICU for the air leak group was 3±0.5 days Vs 2.25±0.2 days in the non-air leak group (P<.01). 24 infants in the air leak group received more than 4 doses of antibiotics compared to 10 infants in the RD group (P<.05). All other infant data collected were not significantly different between the two groups. Term infants who developed air leaks were subjected to a longer period of rupture of membranes prior to labor as well as a longer duration of labor. The burden of illness was significantly higher for those infants who developed air leaks. Speculation: Perinatal rather than postnatal factors appear to be more important in the development of air leak syndromes in term infants.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».