Visual function scale for identification of infants with low respiratory compliance

Aim: Precise estimation of respiratory function is essential to optimise neonatal respiratory care. However, current clinical scores have not been validated with quantitative measures of respiratory function. The aim of this study was to develop a physiological scoring system to predict low respirat...

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Main Authors: Eimei Harada, Masahiro Kinoshita, Sachiko Iwata, Mamoru Saikusa, Kennosuke Tsuda, Ryota Shindou, Takeshi Sahashi, Shin Kato, Yasumasa Yamada, Shinji Saitoh, Osuke Iwata
Format: Article
Language:English
Published: Elsevier 2019-12-01
Series:Pediatrics and Neonatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957218306077
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author Eimei Harada
Masahiro Kinoshita
Sachiko Iwata
Mamoru Saikusa
Kennosuke Tsuda
Ryota Shindou
Takeshi Sahashi
Shin Kato
Yasumasa Yamada
Shinji Saitoh
Osuke Iwata
author_facet Eimei Harada
Masahiro Kinoshita
Sachiko Iwata
Mamoru Saikusa
Kennosuke Tsuda
Ryota Shindou
Takeshi Sahashi
Shin Kato
Yasumasa Yamada
Shinji Saitoh
Osuke Iwata
author_sort Eimei Harada
collection DOAJ
description Aim: Precise estimation of respiratory function is essential to optimise neonatal respiratory care. However, current clinical scores have not been validated with quantitative measures of respiratory function. The aim of this study was to develop a physiological scoring system to predict low respiratory dynamic compliance of <0.6 ml/cmH2O/kg. Methods: Forty-four newborn infants were studied before (dynamic compliance) and shortly after scheduled extubation (physiological signs). A novel scoring system was developed based on the association between physiological signs and dynamic compliance. Results: The respiratory rate was identified as the primary independent variable for dynamic compliance in the univariate analysis. The prediction score for low dynamic compliance comprised the presence of nasal flaring, see-saw respiration, suprasternal/intercostal retraction, and the respiratory rate ranks (0–3). The area under the receiver–operating characteristics curve of the composite score had discriminatory capability of 0.86 (95% confidence interval: 0.75–0.97) to predict low dynamic compliance with the optimal cut-off value of ≥3 (sensitivity, 0.882; specificity, 0.667). Conclusion: Our novel scoring system might help predict newborn infants with low dynamic compliance, who may require escalation of respiratory support, or transfer to higher level units. Key Words: Lung compliance, Newborn infant, Respiratory failure, Resuscitation
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spelling doaj-art-3e5b81dcb59d4d09a5375b5db215fc932025-08-20T03:10:02ZengElsevierPediatrics and Neonatology1875-95722019-12-0160661161610.1016/j.pedneo.2019.02.006Visual function scale for identification of infants with low respiratory complianceEimei Harada0Masahiro Kinoshita1Sachiko Iwata2Mamoru Saikusa3Kennosuke Tsuda4Ryota Shindou5Takeshi Sahashi6Shin Kato7Yasumasa Yamada8Shinji Saitoh9Osuke Iwata10Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, JapanDepartment of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, JapanCentre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, JapanDepartment of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, JapanDepartment of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, JapanDepartment of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, JapanCenter for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Division of Neonatology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi, JapanCenter for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, JapanCenter for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Perinatal and Neonatal Center, Aichi Medical University, Nagakute, Aichi, JapanCenter for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, JapanDepartment of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Corresponding author. Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho Mizuho, Nagoya, 467-8602 Japan.Aim: Precise estimation of respiratory function is essential to optimise neonatal respiratory care. However, current clinical scores have not been validated with quantitative measures of respiratory function. The aim of this study was to develop a physiological scoring system to predict low respiratory dynamic compliance of <0.6 ml/cmH2O/kg. Methods: Forty-four newborn infants were studied before (dynamic compliance) and shortly after scheduled extubation (physiological signs). A novel scoring system was developed based on the association between physiological signs and dynamic compliance. Results: The respiratory rate was identified as the primary independent variable for dynamic compliance in the univariate analysis. The prediction score for low dynamic compliance comprised the presence of nasal flaring, see-saw respiration, suprasternal/intercostal retraction, and the respiratory rate ranks (0–3). The area under the receiver–operating characteristics curve of the composite score had discriminatory capability of 0.86 (95% confidence interval: 0.75–0.97) to predict low dynamic compliance with the optimal cut-off value of ≥3 (sensitivity, 0.882; specificity, 0.667). Conclusion: Our novel scoring system might help predict newborn infants with low dynamic compliance, who may require escalation of respiratory support, or transfer to higher level units. Key Words: Lung compliance, Newborn infant, Respiratory failure, Resuscitationhttp://www.sciencedirect.com/science/article/pii/S1875957218306077
spellingShingle Eimei Harada
Masahiro Kinoshita
Sachiko Iwata
Mamoru Saikusa
Kennosuke Tsuda
Ryota Shindou
Takeshi Sahashi
Shin Kato
Yasumasa Yamada
Shinji Saitoh
Osuke Iwata
Visual function scale for identification of infants with low respiratory compliance
Pediatrics and Neonatology
title Visual function scale for identification of infants with low respiratory compliance
title_full Visual function scale for identification of infants with low respiratory compliance
title_fullStr Visual function scale for identification of infants with low respiratory compliance
title_full_unstemmed Visual function scale for identification of infants with low respiratory compliance
title_short Visual function scale for identification of infants with low respiratory compliance
title_sort visual function scale for identification of infants with low respiratory compliance
url http://www.sciencedirect.com/science/article/pii/S1875957218306077
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