Newborn infants with respiratory distress have an increased morbidity and mortality. Based on clinical parameters it is possible to identify those infants at significant risk.
Parameters from clinical assessment:
(1) respiratory rate in breaths per minute
(2) presence or absence of cyanosis of lips or oral mucous membranes, with or without supplemental oxygenation
(3) presence or absence of retraction
(4) presence or absence of expiratory grunting
(5) quality of inspiratory breath sounds, assessed in the mid-axillary line
|
Parameter |
Finding |
Points |
|
respiratory rate (breaths/minute) |
< 60 |
0 |
|
|
60 - 80 |
1 |
|
|
> 80 |
2 |
|
|
apneic episode |
2 |
|
cyanosis |
none |
0 |
|
|
on room air |
1 |
|
|
on 40% oxygen |
2 |
|
retraction |
none |
0 |
|
|
mild |
1 |
|
|
moderate or severe |
2 |
|
grunting |
none |
0 |
|
|
audible with stethoscope |
1 |
|
|
audible without stethoscope |
2 |
|
quality of inspiratory breath sounds |
clear |
0 |
|
|
delayed or decreased |
1 |
|
|
barely audible |
2 |
respiratory distress syndrome score =
= (points for respiratory rate) + (points for cyanosis) + (points for retraction) + (points for grunting) + (points for inspiratory breath sound quality)
Interpretation:
• The score at 12-18 hours of age provided the best estimate of prognosis.
|
Time Since Birth |
Score |
Mortality Rate in 1970 |
|
Infants 12-18 hours old |
>=8 |
100% |
|
|
7 |
64% |
|
|
6 |
40% |
|
|
< 6 |
0% |
|
Infants 24-30 hours old |
>=8 |
60% |
|
|
7 |
58% |
|
|
6 |
50% |
|
|
< 6 |
0% |
The score also correlates with acid-base status and arterial blood gas values.
Specialty: Pulmonology, Pedatrics
