جستجوی مقالات مرتبط با کلیدواژه « آزمایش تکان آسپیره ترشحات معده » در نشریات گروه « پزشکی »

Hyaline membrane disease (HMD) is one of the most common respiratory diseases in preterm infants. The main cause of the disease is surfactant deficiency and its clinical symptoms include respiratory distress tachypnea, cyanosis, granulation, and increased oxygen demand. There are generally two methods of administering surfactants, 1- prophylactic 2- Rescue. This study aimed to evaluate the effect of gastric aspiration impulse test on predicting the need for surfactant in neonates.

This study was a descriptive-analytic study in which all newborn infants less than or equal to 34 weeks of age had respiratory distress and clinical symptoms of hyaline membrane disease such as granitic, cyanosis, intraretinal retraction. And sub-ribs were studied and causes other than those listed are exclusion criteria and excluded. The sampling method was easy and data were collected from an oral interview of pregnant mothers, checking the files and completing the questionnaire. Data analysis software was SPSS v21 and descriptive statistics and regression tests were used for odds ratios.

In this study, 62 (68.1%) neonates were male and 29 (31.9%) were female. The mean birth weight of neonates was 1662±593 g and their mean age was 31.7±2.5 weeks. Normal delivery and cesarean section in this study were 35 (38.5%) and 56 (61.5%), respectively. According to the findings, diabetes mellitus had a significant relationship with hyaline membrane disease. Hypertension, addiction, corticosteroid administration, and gender were also significantly associated with membrane disease (P <0.05). According to the present study, there was no significant relationship between the type of delivery and hyaline membrane disease (P> 0.05).

Our study showed that the offspring of mothers with hypertension, addiction, and diabetes were less likely than others to have membrane disease and need to be given surfactants. The administration of corticosteroid drugs to mothers is also associated with the development of hyaline membrane disease.

Early treatment with exogenous surfactant is associated with better outcome in neonates with Hyaline membrane disease (HMD), but diagnosis may only become clear late in the course of the disease. In order to rapidly and reliably identify such neonates, we have evaluated the Gastric aspirate shake test (GAST). Eighty one neonates with gestational age less than 34 weeks enrolled to this study (51 newborns without pulmonary diseases and 31 newborns with HMD). The clinical characteristics of HMD considered as the gold standard of diagnosis. About 1 ml mixture of normal saline (0.5ml) and stomach contents were collected within 30 minutes of birth (0.5ml) were shaking for 15 seconds into a glass test tube. Then 1 ml of 95% ethanol was injected into the test tube and the 2 ml mixture of gastric aspirate, saline and alcohol agitated for a further 15 seconds. After a waiting time of 15 min, the surface of fluid was examined for bubbles to decide the result of shake test. If no bubbles were present then the test was NEGATIVE (very little surfactant). If bubbles were seen around the top of the fluid but not enough bubbles were present to completely cover the surface, then the test was INTERMEDIATE (only some surfactant). If bubbles were present right across the surface of the fluid, then the test was POSITIVE (adequate amounts of surfactant). All infants who developed HMD had negative or intermediate test results. The GAST had a specificity of 66%, sensitivity of 100%, positive predictive value of 64.5% and negative predictive value of 100% for developing HMD. The sensitivity and specificity of the GAST for prediction of surfactant requirement in HMD patients were 100% and 64.8%, respectively, with a positive and negative predictive value of 62.5% and 100%, respectively. We conclude that the GAST on gastric aspirates obtained within 0.5 hour of delivery is a rapid and simple procedure for rule out of HMD and surfactant requirement.