Can Cardiothymic Thoracic Ratio be a Marker of Mortality in Preterm Neonates with Respiratory Distress Syndrome?
Introduction: Thymic size is measured as Cardiothymic: Thoracic ratio (CT/T ratio) in chest X-ray. In a state of stress, the thymus tissue rapidly involutes, owing principally to the thymocytolytic effect of glucocorticosteroids. Different pre and postnatal factors affect thymic size in neonates...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2021-04-01
|
| Series: | Indian Journal of Neonatal Medicine and Research |
| Subjects: | |
| Online Access: | https://www.ijnmr.net/articles/PDF/2301/48393_CE[Ra1]_F(SHU)_PF1(SY_SHU)_PFA(SY_KM)_PN(KM).pdf |
| Summary: | Introduction: Thymic size is measured as Cardiothymic:
Thoracic ratio (CT/T ratio) in chest X-ray. In a state of stress,
the thymus tissue rapidly involutes, owing principally to the
thymocytolytic effect of glucocorticosteroids. Different pre
and postnatal factors affect thymic size in neonates.
Aim: To determine the thymic size in preterm neonates with
Respiratory Distress Syndrome (RDF), its relation to survival
to determine which antenatal and postnatal factors influence
thymic size.
Materials and Methods: This prospective observational study
was carried out in neonatal units of tertiary care hospital in
North India from May 2018 to September 2019. Premature
(<37 weeks gestation) neonates admitted in NICU with clinical
and radiological evidence of RDS were included in the study.
CT/T ratio was measured in chest X-ray. The quantitative data
was presented as mean and standard deviation (SD) and
were compared using student t-test, one-way ANOVA test
and continuous non parametric data were compared using
Pearson correlation coefficient test.
Results: Mean age of 110 studied neonates was 32.07±1.76
weeks. The mean±SD CT/T in the study was 0.361±0.043.
Mean CT/T ratio (0.372±0.043) of non survivor (44) was higher
(0.356±0.043) than survivor neonates (66). This difference
was statistically not significant (p-value=0.058). Mean CT/T
ratio >0.361 has sensitivity 59.09% and specificity 68.18%
for non survivor group. Logical regression analysis for
probability of survival showed that as CT/T ratio increases
probability of survival decreases. Mean CT/T ratio was not
affected by gestational age, sex, mode of delivery, use of
antenatal steroid, pre-eclampsia, mother’s parity, perinatal
asphyxia and sepsis.
Conclusion: The mean CT/T ratio was higher in non surviving
neonates with RDS as compared to those who survived.
Mean CT/T ratio is a poor predictor for mortality in premature
neonates with RDS. |
|---|---|
| ISSN: | 2277-8527 2455-6890 |