A Clinical Epidemiologic Study Of Neonatal Respiratory Failure In A Children's Hospital Of Hunan Province

Objective:Exploring the distribution of cases, primary diseases, clinical treatment, clinical outcomes as well as the influencing factors of Mortality in 1108 cases of neonatal respiratory failure, in order to provide theoretical guidance for improving the clinical treatment's level and also to provide references for carrying out the multi-center clinical epidemiological study of neonatal respiratory failure in Hunan province in future.Methods:In the form of the questionnaires, we collected 1108 cases of standard compliant patients. The clinical data is inputted by Epidata 3.0 and statistical analyzed with software SPSS 13.0.The main content included the basic information of children and mothers, birth circumstances, primary diseases, complications, respiratory treatment, treatment consequence, mortality and its influencing factors. The rank sum test was used to compare the continuous variables in skewed distribution and ordered categorical variable, the chi square test was used to compare disordered categorical variables, and the non-conditional Logistic regression analysis was used to analyze the determinants. The test level is 0.05.Results:In all NRF infants, the median gestational age is 37.1 weeks, median birth weight is 2600g, median age is 0.71 days and median SNAPPE-â…¡score is 15.Accounted for 18.9% of the children are small for gestational age, in which the male/female sex ratio is up to 3:1; 4.6% of the children were born out of hospital,11.7% w-ere multiple births,60.9% were cesarean section,25.7% of the children combined with congenital deformity. The major primary disease are followed by respiratory distress syndrome(30.5%), Pneumonia/sepsis(23.5%) and Transient Tachypnea (13.2%); complications are followed by Pneumonia/sepsis(20.1%), Patent Ductus Arteriosus(12.2%) and periventricular-intraventricular hemorrhage (7.9%).26.2% of children received nCPAP treatment,13.0% received high-frequency oscillatory ventilation,13.4% received pulmonary surfactant, 8.7% received inhaled nitric oxide therapy. The median length of stay is 13.81 days and median cost is RMB 14,465. The case fatality is 24.2%, and the risk factors are congenital malformations (OR=2.06), inhaled nitric oxide therapy (OR=3.30), high SNAPPE-â…¡score (OR=37.98), elder age (OR=3.36) and low birth weight (OR=10.57). The protective factors are nCPAP (OR=0.53), prolonged mechanical ventilation (OR=0.22).Conclusion:Most NRF infants were male and born in hospitals. The primary diseases of NRF are RDS, Pneumonia/sepsis and TT; The main complications were Pneumonia/sepsis, PDA and PVH-IVH; the main respiratory treatments were nCPAP, invasive mechanical ventilation, high frequency oscillatory ventilation, inhaled nitric oxide therapy and PS replacement therapy; the hospital costs are relatively high, financial burden was heavy. The case fatality is high and the risk factors are congenital malformations, Nitric Oxygen inhalation treatment, high SNAPPE-â…¡score, elder age and low birth weight. The protective factors are nCPAP and prolonged mechanical ventilation.