中国江苏省新生儿呼吸衰竭的临床现状：患者人口统计学资料、NICU 治疗干预措施和患者结局。

The current clinical landscape of neonatal respiratory failure in Jiangsu Province of China: patient demographics, NICU treatment interventions, and patient outcomes.

机构信息

Department of Neonatology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, Jiangsu, China.

Department of Neonatology, Children's Hospital of Nanjing Medical University, Gulou District, No.72, Guangzhou Road, Nanjing, 210008, Jiangsu, China.

出版信息

BMC Pediatr. 2024 Apr 25;24(1):272. doi: 10.1186/s12887-024-04741-y.

DOI:10.1186/s12887-024-04741-y

PMID:38664650

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11044282/

Abstract

INTRODUCTION

Neonatal respiratory failure (NRF) is a serious condition that often has high mortality and morbidity, effective interventions can be delivered in the future by identifying the risk factors associated with morbidity and mortality. However, recent advances in respiratory support have improved neonatal intensive care units (NICUs) care in China. We aimed to provide an updated review of the clinical profile and outcomes of NRF in the Jiangsu province.

METHODS

Infants treated for NRF in the NICUs of 28 hospitals between March 2019 and March 2022 were retrospectively reviewed. Data collected included baseline perinatal and neonatal parameters, NICU admission- and treatment-related data, and patient outcomes in terms of mortality, major morbidity, and survival without major morbidities.

RESULTS

A total of 5548 infants with NRF were included in the study. The most common primary respiratory disorder was respiratory distress syndrome (78.5%). NRF was managed with non-invasive and invasive respiratory support in 59.8% and 14.5% of patients, respectively. The application rate of surfactant therapy was 38.5%, while that of neonatal extracorporeal membrane oxygenation therapy was 0.2%. Mortality and major morbidity rates of 8.5% and 23.2% were observed, respectively. Congenital anomalies, hypoxic-ischemic encephalopathy, invasive respiratory support only and inhaled nitric oxide therapy were found to be significantly associated with the risk of death. Among surviving infants born at < 32 weeks of gestation or with a birth weight < 1500 g, caffeine therapy and repeat mechanical ventilation were demonstrated to significantly associate with increased major morbidity risk.

CONCLUSION

Our study demonstrates the current clinical landscape of infants with NRF treated in the NICU, and, by proxy, highlights the ongoing advancements in the field of perinatal and neonatal intensive care in China.

摘要

介绍

新生儿呼吸衰竭（NRF）是一种严重的疾病，通常具有较高的死亡率和发病率，通过识别与发病率和死亡率相关的危险因素，可以为未来提供有效的干预措施。然而，呼吸支持的最新进展改善了中国新生儿重症监护病房（NICU）的护理。我们旨在提供江苏省 NRF 临床特征和结局的最新综述。

方法

回顾性分析 2019 年 3 月至 2022 年 3 月期间 28 家医院 NICU 治疗的 NRF 婴儿。收集的数据包括围产期和新生儿基本参数、NICU 入院和治疗相关数据以及死亡率、主要发病率和无主要发病率的生存情况。

结果

共纳入 5548 例 NRF 婴儿。最常见的原发性呼吸障碍是呼吸窘迫综合征（78.5%）。59.8%和 14.5%的患者分别接受了无创和有创呼吸支持治疗。表面活性物质治疗的应用率为 38.5%，而新生儿体外膜氧合治疗的应用率为 0.2%。死亡率和主要发病率分别为 8.5%和 23.2%。先天性畸形、缺氧缺血性脑病、仅有创呼吸支持和吸入一氧化氮治疗与死亡风险显著相关。在胎龄<32 周或出生体重<1500 g 的存活婴儿中，咖啡因治疗和重复机械通气与主要发病率风险增加显著相关。