Clinical features of severe respiratory failure in children at 37 weeks’ gestational age

Purpose is to determine the clinical features of severe respiratory failure in newborns whose gestational age was 37 weeks. Methods Design – it was a retrospective, controlled, non-randomized, single-center study. 40 patients satisfied the inclusion and exclusion criteria. 7 (1.1%) children died. Depending on their gestational age, patients were divided into two groups. The basic group (n= 279) included newborns whose gestational age was 37 weeks. Children born at 34–36 weeks of pregnancy were in the group of comparison (n= 361). Patients from the both groups underwent a comparable intensive treatment and had similar values of initial treatment of ALV such as respiratory volume of at least 6 ml/kg, PEEP of 4–6 cm H2O, PRVS mode. BioStat was used for statistical analysis. Results. The rate of episodes of severe respiratory failure is quite comparable between the basic group and the group of comparison. Non-invasive ALV was more frequently used by patients from the basic group (χ2=4.23; p=0.05). Fetal growth restriction and higher pressure in the pulmonary artery was an important feature of respiratory failure course in children whose gestational age was 37 weeks as it resulted in a significantly higher rate of pulmonary hemorrhage episodes (χ2=9.608; р=0.02). Respiratory issues typical of the children can be seen only in those born by Cesarean section. Conclusion. The features of severe respiratory failure at 37 weeks’ gestational age include the children’s development when Cesarean section is used, fetal growth restriction and higher pressure in the right ventricle with more frequent episodes of pulmonary bleeding.

newborns, gestational age, respiratory failure