Respiratory Distress NeonatalNoninvasive VentilationIntubationScoring Systems
Study summary
This study aimed to compare the Silverman-Andersen score and the Downes score in predicting noninvasive ventilation (NIPPV) failure in preterm and term infants who received NIPPV support due to postnatal respiratory distress, as well as to evaluate the agreement of these scoring systems with other methods used to assess the severity of respiratory distress.
The present study was designed as a prospective, multicenter, observational study conducted with neonates undergoing noninvasive ventilation.
Eligibility
Sex
ALL
Min age
2 Hours
Max age
12 Hours
Healthy volunteers
No
Inclusion Criteria:
* Preterm infants born at \>28 weeks of gestation or term infants born at ≥37 weeks of gestation.
* Development of respiratory distress within the first 6 hours after birth, defined as the presence of at least two of the following: Respiratory rate ≥60/min, Subcostal/intercostal retractions, Grunting.
* Persistence of respiratory distress for more than 6 hours.
* Age within the first 12 hours of life.
* Silverman-Andersen score ≥3.
* Receiving NIPPV support.
Exclusion Criteria:
* Major congenital malformations.
* Airway or pulmonary anomalies.
* Cardiovascular or respiratory instability due to sepsis.
* Cyanotic congenital heart disease.
* Severe intraventricular hemorrhage.
* Contraindications for NIPPV therapy (e.g., congenital nasal anomalies, congenital diaphragmatic hernia, abdominal wall defects).
* Requirement of intubation or chest compressions in the delivery room.
* Requirement of intubation within the first hour of life.
* Death within the first 24 hours of life.
* Gestational age ≤28 weeks.
* Diagnosis of air leak syndrome (pneumothorax) prior to initiation of NIPPV therapy.
Primary outcome measure(s)
To determine the predictive role of the Silverman-Andersen score for noninvasive ventilation failure at 24 and 72 hours of life. — 24 hours and 72 hours after birth Noninvasive ventilation failure will be defined as the need for intubation in an infant receiving NIPPV. The Silverman-Andersen score will be assessed at 30 minutes after initiation of NIPPV therapy, and its predictive value for noninvasive ventilation failure will be evaluated at 24 and 72 hours of life. The Silverman-Andersen score assesses upper chest movement, intercostal retractions, subxiphoid retractions, nasal flaring, and air entry to the lungs on auscultation. Each parameter is scored between 0 and 2, yielding a total score ranging from 0 to 10. Higher scores indicate greater severity of respiratory distress (5).
To determine the predictive role of the Downes score for noninvasive ventilation failure at 24 and 72 hours of life — 24 hours and 72 hours after birth Noninvasive ventilation failure will be defined as the need for intubation in an infant receiving NIPPV. The Downes score will be assessed at 30 minutes after initiation of NIPPV therapy, and its predictive value for noninvasive ventilation failure will be evaluated at 24 and 72 hours of life. The Downes score evaluates cyanosis, respiratory rate, retractions, grunting, and air entry to the lungs on auscultation. Each parameter is scored between 0 and 2, yielding a total score ranging from 0 to 10. Higher scores indicate greater severity of respiratory distress (5).
Trial sites (4)
Facility
City
Region
Status
Akdeniz University School of Medicine, Department of Neonatology
Antalya
Antalya
Antalya Training and Research Hospital, Department of Neonatology
Antalya
Antalya
Mugla Training and Research Hospital, Department of Neonatology
Muğla
Mentese
Sanliurfa Training and Research Hospital, Department of Neonatology
Sanliurfa
Şanlıurfa
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This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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