Evaluated using measures such as pulse oxygen saturation (SpO2) or arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2), or the Oxygen Saturation Index (OSI). This calculation provides a non-invasive measure of oxygenation efficiency. Research has shown that OSI is just as reliable as the Oxygenation Index (OI) in evaluating the severity of pediatric acute respiratory distress syndrome (PARDS). Since OSI uses peripheral oxygen saturation (SpO₂) instead of arterial blood gases, it serves as a practical and effective alternative, particularly in settings where frequent arterial sampling is not feasible.

The Oxygen Saturation Index (OSI) is determined using the formula:

(FiO₂ × mean airway pressure × 100) ÷ SpO₂ (14).

The Silverman-Anderson scores are widely used clinical tools designed to evaluate the severity of respiratory distress in newborns. Both systems rely on objective clinical parameters to quantify respiratory difficulty. The Silverman-Anderson score specifically measures five key signs: chest retractions in the upper and lower thorax, subxiphoid retraction, nasal flaring, and audible grunting during exhalation. Each of these indicators is rated on a scale from 0 to 2, allowing healthcare providers to systematically assess and monitor the progression or improvement of respiratory distress in neonates.

A structured chest physiotherapy protocol will be applied in neonates to enhance airway clearance by targeting specific lung segments. This includes appropriate positioning-supine for upper lobes and side-lying for lower lobes-combined with gentle chest percussion to mobilize secretions while avoiding sensitive areas. Sessions last 4-5 minutes and are repeated every 3 hours, with careful monitoring of vital signs and precautions such as avoiding treatment soon after feeding. Additionally, the thoracic squeezing technique is used to simulate a cough by applying gentle, rhythmic compressions during expiration in a side-lying position. Performed for about 10 minutes on each side after drainage or percussion, it helps move secretions toward central airways, particularly in infants with weak cough reflexes, with continuous monitoring to ensure safety and immediate cessation if distress occurs.

Evaluated using measures such as pulse oxygen saturation (SpO2) or arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2), or the Oxygen Saturation Index (OSI). This calculation provides a non-invasive measure of oxygenation efficiency. Research has shown that OSI is just as reliable as the Oxygenation Index (OI) in evaluating the severity of pediatric acute respiratory distress syndrome (PARDS). Since OSI uses peripheral oxygen saturation (SpO₂) instead of arterial blood gases, it serves as a practical and effective alternative, particularly in settings where frequent arterial sampling is not feasible.

The Oxygen Saturation Index (OSI) is determined using the formula:

(FiO₂ × mean airway pressure × 100) ÷ SpO₂ (14).

The Silverman-Anderson scores are widely used clinical tools designed to evaluate the severity of respiratory distress in newborns. Both systems rely on objective clinical parameters to quantify respiratory difficulty. The Silverman-Anderson score specifically measures five key signs: chest retractions in the upper and lower thorax, subxiphoid retraction, nasal flaring, and audible grunting during exhalation. Each of these indicators is rated on a scale from 0 to 2, allowing healthcare providers to systematically assess and monitor the progression or improvement of respiratory distress in neonates.