Navarro-Romero A, Martínez-Félix NS, Peraza-Garay FJ, Soto-Castellanos IA, García-Vázquez RA

Language: Spanish
References: 15
Page: 124-135
PDF size: 201.94 Kb.

ABSTRACT

Objective: Determine the number of lamellar bodies (LB) in newborns (NB) with respiratory distress syndrome (RDS). Material and methods: Prospective, descriptive study, diagnostic test. All NB delivered in the Civil Hospital of Culiacán were included in the period from April 1, 2018 to November 30, 2020, samples of amniotic fluid were obtained by gastric juice aspiration by placing an gastric gavage during the first 45 minutes of life, the determination of LB was carried out by means of a hematological cell counter through the platelet channel, (SYSMEX model XE-2100) to determine RDS in NB. Results. 343 samples of amniotic fluid obtained by gastric juice aspiration were analyzed, of which 54.5% (n = 187) were male and 45.5% (n = 156) female. Of the total, 76 were premature (RNPT) and 267 term (RNT). 138 NBs presented RDS, 42.8% (n = 59) were RNPT and 57.2% (n = 79) were RNT. In the NBs who presented RDS with the SILVERMAN ANDERSON (SA) scale, a significant association was observed for the diagnosis of RDS. Median LB counts between preterm and term were significantly different (p = .005). The median for RNT was 82.0 (95% CI 68, 100) and for RNPT 43.5 (95% CI 33.97,67.07). In the newborns with RDS, the RNPT had a significantly lower LB count (p = .000) with a median 40 (95% CI 31.5, 62) than the RNT with a median 99 (95% CI 74, 166). A significant relationship (p = .000) was observed between the LB count and the SA scale, higher values on the SA scale corresponded to a lower LB count. The cut-off point was estimated at 81,500 CL in RNPT, with a sensitivity of 72.9% and a specificity of 52.9% for the presence of RDS, with PPV of 84.3% and NPV of 36%. Of the patients who presented RDS, 15 required application of exogenous surfactant, 14 of them were premature, requiring invasive mechanical ventilation in 8 of these patients. Conclusions. The CL count in amniotic fluid is a promising, quick and simple test for predicting RDS, but the simple quantification of CL is not by itself sensitive and specific to determine the presence of the disease, however, including the association of the SA scale, it was observed that the lower the amount of CL, the higher its score to produce the disease.

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