Abstract

OBJECTIVES
We retrospectively investigated incidence, morbidity, and mortality of neonatal respiratory failure (NRF) in China, with special emphasis on surfactant treated very immature infants.
METHODS
NRF was defined as respiratory hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure for at least 24 hours.
RESULTS
There were 6864 cases of NRF, composing 19.7% of total admissions to 55 NICUs in 2008. Of these cases, 62.8% were preterm, and 16.4% of very low birth weight (VLBW, <1500 g). The primary diseases were respiratory distress syndrome (RDS, 43.9%), pneumonia/sepsis (21.7%), transient respiratory insufficiency (14.7%), transient tachypnea (8.1%), and meconium aspiration syndrome (7.0%). Surfactant was given to 26.8% of infants with NRF and 54.8% infants with RDS. The survival rate of surfactant-treated RDS was 79.9% compared to 71.8% in those not receiving surfactant (P < .001). This was also true in those of VLBW, 59.8% vs 52.2% (P = .035), respectively. The overall survival rate in NRF cases was 75.3%, but it was 58.1% among VLBW infants; for those infants of 25, 26, and 27 to 28 weeks' gestational age, the survival rates were ∼6%, 30%, and 50%, respectively; and the survival rates for infants with meconium aspiration syndrome and pneumonia/sepsis were 70.3% and 71.4%, respectively. The care burden was associated with high treatment withdrawal and death rate.
CONCLUSIONS
The outcomes of NRF, especially in extremely premature infants, reflect both progress and persistent limitations in providing respiratory support in the emerging NICUs of China, but overall survival for sick newborns had improved steadily.

Links

Publisher Full Text

Authors

Wang H, Gao X, Liu C, Yan C, Lin X, Yang C, Lin Z, Zhu W, Yang Z, Yu F, Qiu Y, Liu X, Zhou X, Chen C, Sun B, Chinese Collaborative Study Group for Neonatal Respiratory Diseases

Institution

Children’s Hospital of Fudan University and the Laboratory of Neonatal Diseases of Ministry of Health, Shanghai, China.

Source

Pediatrics 129:3 2012 Mar pg e731-40

MeSH

Cause of Death
China
Cohort Studies
Female
Hospital Mortality
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Prognosis
Pulmonary Surfactants
Respiration, Artificial
Respiratory Distress Syndrome, Newborn
Retrospective Studies
Risk Assessment
Severity of Illness Index
Statistics, Nonparametric
Survival Rate

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22331337