Performance of the Silverman Andersen Respiratory Severity Score in predicting PCO2 and respiratory support in newborns: a prospective cohort study

Anna Bruett Hedstrom, Nancy E Gove, Dennis E Mayock, Maneesh Batra, Anna Bruett Hedstrom, Nancy E Gove, Dennis E Mayock, Maneesh Batra

Abstract

Objective: To determine if the Silverman Andersen respiratory severity score, which is assessed by physical exam, within 1 h of birth is associated with elevated carbon dioxide level and/or the need for increased respiratory support.

Study design: Prospective cohort study including 140 neonates scored within 1 h of birth. We report respiratory scores and their association with carbon dioxide and respiratory support within 24 h.

Results: Carbon dioxide level correlated with respiratory score (n = 33, r = 0.35, p = 0.045). However, mean carbon dioxide for patients with score <5 vs. ≥5 did not differ significantly (56 vs. 67, p = 0.095). Patients with respiratory scores ≥5 had respiratory support increased within 24 h more often than those with scores <5 (79% vs. 28%, p < 0.001).

Conclusion: The Silverman Andersen respiratory severity score may be valuable for predicting need for escalation of respiratory support and facilitate decision making for transfer in low-resource settings.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The Silverman Andersen Respiratory Severity Score (RSS) evaluates five parameters of work of breathing and assigns an overall score with a patient breathing comfortably a “0” and a patient in severe respiratory distress a “10”. Reprinted with permission from ref. [10] as modified from ref. [6]
Fig. 2
Fig. 2
Flowchart of patient enrollment via convenience sampling. HA hospital assistant, RSS Silverman Anderson Respiratory Severity Score
Fig. 3
Fig. 3
Correlation between arterial PCO2 and respiratory sevety score
Fig. 4
Fig. 4
Respiratory severity score cutoff to predict increased respiratory support in the first 24 h. a Receiver operating characteristic curve. b Sensitivity, specificity and likelihood ratios (LR) of each cutoff. RSS Silverman Andersen respiratory severity score, N/A not applicable given divisor is 0, dns data not sufficient

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Source: PubMed

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