Performance of the Silverman Andersen Respiratory Severity Score in predicting PCO(2) and respiratory support in newborns: a prospective cohort study

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.