# Investigation of the Effectiveness of First Measured Arterial/Cord Blood Gas and Laboratory Results in Predicting the Treatment Model in Newborns Diagnosed With Transient Tachypnea

## TL;DR

This study shows that early blood gas and lab results can help predict the type of respiratory support needed for newborns with transient tachypnea.

## Contribution

The study identifies specific blood gas and lab parameters that predict the need for different respiratory support models in TTN infants.

## Key findings

- Low serum calcium, phosphorus, and sodium levels are linked to the need for invasive ventilation in TTN infants.
- Blood gas pH and pCO2 values correlate with the duration of oxygen therapy in TTN infants.
- ROC analysis identified cutoff values for calcium and pH to predict specific respiratory support requirements.

## Abstract

The aim of this study was to investigate the predictive effect of laboratory results and blood gas values on the selection of respiratory support models in infants diagnosed with transient tachypnea of the newborn (TTN).

The study was designed as a single‐center, retrospective study. Infants born with gestational age ≥ 35 weeks diagnosed with TTN during a 2‐year period were included. Demographic characteristics, laboratory parameters, respiratory support models, and length of hospital stay were recorded. The relationship between the obtained parameters and the percentage and duration of oxygen requirement, nasal continuous positive airway pressure (nCPAP), nasal synchronized intermittent mandatory ventilation (nSIMV), intubation, and hospitalization duration was evaluated.

The study was completed with 327 infants. A correlation was found between pH and pCO2 values in the first blood gas analysis and the duration of oxygen administration (p : 0.019 and p : 0.001), and between serum calcium levels and peak sodium levels and the duration of nSIMV (p : 0.04 and p : 0.023). Low serum calcium, phosphorus, and initial sodium levels were identified in infants requiring invasive ventilation (p : 0.001, p : 0.006, and p : 0.012, respectively). In the ROC analysis used to predict intubation, the cutoff value for calcium was determined as < 8.11 mg/dL (AUC 0.771, [95% CI: 0.669–0.872], p : <0.001). For predicting the need for nCPAP, the cutoff value for pH in the first blood gas analysis was < 7.32 (AUC 0.705, [95% CI: 0.586–0.823], p : 0.003), and for predicting the need for nSIMV, the cutoff value for pH was < 7.28 (AUC 0.599, [95% CI: 0.535–0.663], p : 0.003).

It was determined that the initial blood gas pH and pCO2 values, as well as serum sodium, calcium, and phosphorus levels, could be used to predict the treatment model in infants diagnosed with TTN. Low calcium, phosphorus, and sodium levels were found in TTN‐diagnosed infants requiring invasive mechanical ventilation.