الفهرس 
List of abbreviations
Neonatal lung developmentOnly 14 pages are availabe for public view
 |  | from | 191 |  |  |
| | | from | 191 | | |
Abstract
Respiratory distress is considered one of the most major causes of morbidity and mortality in the neonatal period. Early detection and management is considered crucial for physicians working in the neonatal intensive care units. Most common causes of neonatal respiratory distress are transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration syndrome and congenital pneumonia. Clinical features of neonatal respiratory distress are tachypnea (respiratory rate >60 breath per minute), nasal flaring, chest wall retractions, grunting and cyanosis. Our study is a prospective cohort study evaluating the role of chest ultrasound in the diagnosis of common respiratory disorders in the early neonatal period especially TTN, RDS and congenital pneumonia. It included 46 neonates who presented with respiratory distress in the first 48 hours of life, where 23 cases were diagnosed as transient tachypnea of newborn, 22 as respiratory distress syndrome and one as congenital pneumonia. As regards gestational age and birth weight, they were significantly higher in TTN group compared to RDS group, while male sex and caesarean section were high but comparable in both groups. History of prolonged rupture of membranes was not significantly different between both groups. Chest auscultation revealed equal intensity of breath sounds significantly higher in TTN group while diminished intensity of breath sounds and crepitations were significantly higher in RDS group compared to TTN. Need for oxygen supplementation through nasal cannula was higher in TTN group compared to RDS, while mechanical ventilation was significantly higher in RDS with no difference between both groups regarding need for NCPAP. Duration of respiratory support was significantly higher in RDS group. Surfactant administration was limited to 59% of the RDS cases while none of TTN neonates received it. Laboratory investigations including CBC and CRP showed no difference between both groups. Arterial blood gases showed high percentage of respiratory acidosis among RDS neonates with no difference in BE or HCO3. Initial blood culture for neonates suspected with early onset sepsis showed no positive bacterial growth. Plain x-ray chest findings were informative in both groups where in TTN group it showed increased lung volume, parahilar and peribronchial marking and fissural effusion in all neonates while in RDS cases, it showed air bronchograms, lung haziness or white lungs in all cases. These radiological findings are typically diagnostic of each of TTN and RDS. from this study we can conclude that gestational age and birth weight are significantly lower while surfactant need, mechanical ventilation and duration of respiratory support are significantly higher in RDS compared to TTN cases. Chest ultrasound is a reliable method for diagnosis of TTN where double lung point is specific and consistent with TTN and seems to rule out other diagnoses that reduces the risk of over treatment. B-lines are found to be sensitive and specific for RDS and pleural line abnormalities are also highly specific for RDS diagnosis. Performance of chest US is simple and can be performed by a clinican. In addition, the interpretation of sonographic pictures does not need much specific training.