A Clinical Score for Predicting The Level of Respiratory Care in Infants With Respiratory Distress Syndrome

Abstract

A scoring system was developed to predict the need for transferring infants with respiratory distress syndrome (RDS) from community hospitals to spe cialized respiratory care centers. five clinical and laboratory determinations (birthweight, clinical RDS score, FIO2, PCO2 and pH) recorded from 100 infants with RDS during one year were utilized in a score with values ranging from 0 to 10. Application of the score to 159 with RDS during the following year showed that: (1) 73 per cent of infants scoring ≤3 received only oxygen by hood; (2) 75 per cent of infants scoring 4-5 required continuous positive air way (CPAP); and (3) 87 per cent of scoring ≥6 needed me chanical ventilation (MV). Mean scores were significantly different (p < 0.02) for each type of respiratory therapy employed: oxygen by hood (2.30 ± 0.19 S.E.M.); CPAP (4.27 ± 0.16 S.EIM.); MV (6.72 ± 0.25 S.E.M.). The accuracy and simplicity of the score make it valuable for the physician in the community hospital to assist in deciding when to transfer a neonate with RDS for more intensive respiratory therapy.