Date of Award

Winter 1-4-2019

Document Type

Dissertation

Degree Name

PharmD

Department

Department of Pharmacy Practice

First Advisor

Dr. Leslie Edward Lewis

Abstract

Background: Respiratory Distress Syndrome (RDS) is breathing disorder that affects the newborns especially preterm neonates, extremely low birth weight and very low birth weight neonates. This is due to lack of surfactant production in the lungs of a premature baby. Surfactant therapy and oxygen support improves the condition of the neonate with RDS. Use antenatal steroid prevents the occurrence of RDS/reduces the severity of RDS. This study is necessary to assess which surfactant is better, risk factors associated with RDS and comorbidities of neonates present along with RDS. Objectives: The objectives of the studies are to compare the surfactants used in the treatment of respiratory distress syndrome in neonates, assessing risk factors associated with RDS, to evaluate correlation of RDS with other comorbid conditions, to evaluate use of steroids in pregnant mothers and its effects on Neonatal Respiratory Distress syndrome. Methodology: A retrospective study was conducted over one year where 610 patients were enrolled based on inclusion and exclusion criteria of the study. Their relevant demographics, etiology, treatment patterns were noted. IBM SPSS version 20 was used for statistical analysis. Results: A total of 610 patients diagnosed with RDS were included in the study. The mean age of the study population was found to be 31.80±3.161 weeks and the mean birth weight was found to be 1647.28±717.31 grams. The incidence of RDS was higher in males (58.03%), extremely low birth weight and low birth weight babies 8.85% and 47.04% respectively, caesarean section delivery 77.04% along with other risk factors such as preeclampsia, IDM, PROM and presence of complications of prematurity associated with RDS. It was found that Curosurf group required less NCPAP as compared to Survanta and Neosurf (p=0.010). Curosurf and Survanta significantly reduced pCO2 values (p=0.002 and p=0.03 respectively). There was a significant association between APGAR score and severity of RDS at 1 minute and 5 minutes (p=0.00) for both 1 minute and 5 minutes and Gestational age and RDS severity (p=0.00). There was a significant association between the use of antental steroids and reduction in neonatal mortality (p= 0.001).

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