Retrospective Clinical Epidemiologic Study On Neonatal Respiratory Failure In Yanbian Area

Objective:To explore basic information of cases, primary diseases, clinical treatment as well as clinical outcomes in neonatal respiratory failure (NRF) in Yanbian University affiliated Hospital and analysis the clinical retrospective investigation in order to know about the characteristics of the NRF and the treatment conditions of newborn with such critical situation in Yanbian area. Because the epidemiological data of NRF is very important to determine the trend of the disease, to guide,the macro configuration of medical resources rationally, to promote new interventions, to take timely and effective method in order to improve the managements and reduce the mortality of NRF in infants.Methods:In the form of the questionnaires,the clinical chart of infants with respiratory failure cared in Neonatal intensive care unit (NICU) of Yanbian hospital in China during January1,2008to December31,2013were reviewed and the main content included the basic information of infants and mothers, birth circumstances, primary diseases, the application of Pulmonary surfactant(PS), methods of mechanical ventilation, complications, length and cost of hospitalization, and prognosis of these patients. The data was inputted by Excel2003and analyzed retrospectively with SPSS17.0software. Categorical variables were expressed as the number of cases and percentage, using the chi-square test; The measurement data were expressed as(x±s), using the t test; The median (M) and IQR interquartile range were used to describe the continuous variables in skewed distribution. The test level is0.05Results:18.6%of total admissions were infants with respiratory failure. The male/female ratio of the infants was1.8:1. The han nationality/Korean nationality ratio of the infants was3.5:1. The average gestational age(GA) was35.4±4.2weeks, and average birth weight(BW) was2490±868g,Accounted for53.4%of the infants were premature infants.14.8%of the infants were <1500g BW;24.8%of the infants were combined with congenital deformity.45.9%of the infants were born in cunty hospitals and44.6%in tertiary level hospitals; The major primary disease were followed by respiratory distress syndrome(RDS)44.1%,pneumonia/sepsis39.0%and neonatal asphyxial4.5%; complications were followed by pneumonia/sepsis(23.4%), patent ductus arteriosus(9.0%)and pulmonary air leaks (5.9%);21.4%of NRF received pulmonary surfactant(PS)treatment in NICU. Surfactant was used in44.5%of RDS.44.0%of NRF were treated by nCPAP only,22.4%by MV, and33.6%by both. The rate of mortality was32.8%.The mean length of hospital stay was14.5±11.5days and the mean medical cost was16958.8±11397.6CNY for the survivors.Conclusions:There is no difference about rato of NRF between the Korean.nationality and han nationality.The most common causes of neonatal respiratory failure were respiratory distress syndrome, pulmonary infection/septicaemia and neonatal asphyxia. The most common complications were pulmonary infection/septicemia, patent ductus arteriosus and pulmonary air leaks; Assisted ventilation treatment with nCPAP was the main ventilation method, the application of PS in RDS was low. The mortality and medical costs of NRF were high and the economic burden of NRF was heavy.