Xian Municipal Childrens Hospital

Xi’an, China

Xian Municipal Childrens Hospital

Xi’an, China

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Zhang L.,Fudan University | Qiu Y.,Ningxia Medical University | Yi B.,Women And Childrens Hospital Of Gansu Province | Ni L.,Northwest Women and Children Hospital Maternity Hospital of Shaanxi Province | And 10 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Objectives: We aimed to evaluate the efficacy of respiratory support and surfactant in incidence, management and outcome of neonatal hypoxemic respiratory failure (NRF) in Chinese emerging regional neonatal–perinatal care system in the era of universal health insurance policy. Study design: Clinical data of NRF were prospectively collected in 12 consecutive months from 2011 to 2012 in 12 neonatal intensive care units (NICU) in major cities of Northwest China. NRF was defined as hypoxemia requiring nasal continuous positive airway pressure (nCPAP) or intratracheal ventilation combined with surfactant for at least 24 h, with associated risk factors, mortality rate and major co-morbidities analyzed. Results: Among 9816 admissions, there were 1324 NRF cases with 60.2% being preterm. The incidence of NRF was 13.4% with a mortality of 15.5%. The major underlying diseases were respiratory distress syndrome (RDS, 38.9%) and pneumonia/sepsis (38.0%). Only 15.9% of NRF and 33.8% of RDS received surfactant, which contributed to >70% and >85% survival in RDS patients of birth weight (BW) < 1500 g and >1500 g, respectively. Multivariate logistic regression analysis showed that premature rupture of membrane ≥ 24 h, very low BW and gestational age < 32 weeks, resuscitation at delivery, illness severity at admission, intratracheal ventilation and sepsis were the independent risk factors for the mortality of NRF. The length and cost of NICU stay for survivors reflected care burden in the era of universal health insurance. Conclusions: Surfactant significantly improved the survival of neonates with NRF and RDS, reflecting the respiratory care standard in emerging regional neonatal–perinatal care network with limited resources. © 2016 Informa UK Limited, trading as Taylor & Francis Group.


PubMed | Ningxia Medical University, Northwest Women and Children Hospital Maternity Hospital of Shaanxi Province, Women and Childrens Hospital of Shanxi Province, Kashi First Hospital of Xinjiang Uygur Autonomous Region and 9 more.
Type: | Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | Year: 2016

We aimed to evaluate the efficacy of respiratory support and surfactant in incidence, management and outcome of neonatal hypoxemic respiratory failure (NRF) in Chinese emerging regional neonatal-perinatal care system in the era of universal health insurance policy.Clinical data of NRF were prospectively collected in 12 consecutive months from 2011 to 2012 in 12 neonatal intensive care units (NICU) in major cities of Northwest China. NRF was defined as hypoxemia requiring nasal continuous positive airway pressure (nCPAP) or intratracheal ventilation combined with surfactant for at least 24h, with associated risk factors, mortality rate and major co-morbidities analyzed.Among 9816 admissions, there were 1324 NRF cases with 60.2% being preterm. The incidence of NRF was 13.4% with a mortality of 15.5%. The major underlying diseases were respiratory distress syndrome (RDS, 38.9%) and pneumonia/sepsis (38.0%). Only 15.9% of NRF and 33.8% of RDS received surfactant, which contributed to>70% and>85% survival in RDS patients of birth weight (BW)<1500g and>1500g, respectively. Multivariate logistic regression analysis showed that premature rupture of membrane 24h, very low BW and gestational age <32 weeks, resuscitation at delivery, illness severity at admission, intratracheal ventilation and sepsis were the independent risk factors for the mortality of NRF. The length and cost of NICU stay for survivors reflected care burden in the era of universal health insurance.Surfactant significantly improved the survival of neonates with NRF and RDS, reflecting the respiratory care standard in emerging regional neonatal-perinatal care network with limited resources.

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