Management of Neonatal Respiratory Distress Syndrome Employing ACoRN Respiratory Sequence Protocol versus Early Nasal Continuous Positive Airway Pressure Protocol

authors:

avatar Asadallah Faghani 1 , * , avatar Pedram Niknafs 2 , avatar Seyed-Abolfazl Afjeh 3 , avatar Mehdi Moradinazer 4 , avatar Bahareh Bahman-Bijari 5

Iranian Journal of Pediatrics: Vol.24, issue 1; 57-63
published online: January 24, 2014
article type: Research Article
received: June 15, 2013
accepted: November 08, 2013

how to cite: Faghani A , Niknafs P , Afjeh S, Moradinazer M , Bahman-Bijari B . Management of Neonatal Respiratory Distress Syndrome Employing ACoRN Respiratory Sequence Protocol versus Early Nasal Continuous Positive Airway Pressure Protocol. Iran J Pediatr. 2014;24(1): 57-63. 

Abstract

Objective: Respiratory distress syndrome (RDS) is a common cause of respiratory distress in premature infants. This study was designed to evaluate two different RDS treatment protocols by comparing the outcomes. Methods: This study was a double center cross sectional study performed from June to December 2012. During that period, 386 neonates with RDS were hospitalized and treated according to two different therapeutic protocols so-called Acute Care of at-Risk Newborns (ACoRN) respiratory sequence protocol (group I) and Early Nasal Continuous Positive Airway Pressure (E-NCPAP) protocol (group II). The variables and main outcomes of this study were gestational age, birth weight, bronchopulmonary dysplasia (BPD), pulmonary hemorrhage (PH), intraventricular hemorrhage (IVH), air leak and mortality rate (MR). Findings: Out of 386 infants, 202 infants were in group I (male 60.4%, female 39.6%, mean gestational age 316/7 weeks, mean birth weight=1688 grams) and group II included 184 infants (male 61.4%, female 38.6%, mean gestational age 32 weeks, mean birth weight 1787 grams), P= 0.07. The ratios of BPD of group I to group II and PH of group I to group two were not significant (P=0.63 and P=0.84, respectively). Air leak ratio in group I was higher than in group II (P=0.001). Although IVH ratio in group II was higher than in group I (P=0.01), grade III and IV IVH was higher in group I (30% vs. 4.6%). In case of MR, it was higher in group I than in group II (P=0.001). Conclusion: According to the findings the incidence of air leak, grade III and IV IVH and MR was less common in E-NCPAP protocol, so it may show the effectiveness of this protocol. The authors suggest that more researches are needed for more accurate results.
 

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