Role of Inhaled Budesonide in Transient Tachypnea of Newborn in low-income country
Abstract
Objective: To evaluate the role of budesonide in managing the transient tachypnea of newborn (TTN).
Study Design: A prospective placebo-controlled non-randomized controlled trial.
Place and Duration: Department of Neonatology, Services Hospital Lahore Pakistan from July 2021 to June 2022.
Material & Methods: There were total 100 neonates, 50 in each group with tachypnea/respiratory distress within 6 hours after birth, with required oxygen more than 25%, along with persistent tachypnea for more than 4 hours and radiological findings suggestive of TTN. The 1st group (steroid group), was given budesonide 2 ml via nebulization. Neonates in the 2nd group (control group) were given 2 ml of distilled sterile water via inhalation. Neonates of both groups were evaluated and compared after 3 days of treatment for clinical outcomes like down score, TTN score, SpO2% and pH. And requirement of non-invasive ventilation in form of continuous positive airway pressure (CPAP) was assessed after 3 days in both groups.
Results: Among 100 neonates with TTN, 51 (51.0%) were male. Mean of gestational age and birth weight was calculated to be 38.5±2.0 weeks and 2.4±0.5 kg respectively. Mode of delivery was cesarean section among 78 (78.0%) neonates. Mean Apgar score at 5 minutes was 8.5±0.7. Mean maternal age was found to be 30.9±5.1 years. After 3 days of treatment in both groups, steroid group was significantly better in comparison to control group in terms of TTN scores and Downs scores {TTN scores (2.2±0.8 vs. 2.8±1.0, p=0.0013), and down scores (3.5±0.5 vs. 4.4±0.9, p<0.0001)} while there was no statistical significant difference among both groups, in terms of SpO2%, pH and number of neonates requiring continuous positive airway pressure (CPAP).
Conclusion: Treatment of inhaled budesonide showed improvement in respiratory rate and respiratory distress in our study.
