Epidemiology of respiratory distress and the illness severity in late preterm or term infants： a prospective multi-center study  

作　　者：MA Xi'ao-lu XU Xue-feng CHEN Chao YAN Chao-ying LIU Ya-ming LIU Ling XIONG Hong SUN Hui-qing LAI Jian-pu YI Bin SHI Jing-yun DU Li-zhong 

机构地区：[1]Neonatology Department, Children's Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 310003,China [2]Neonatology Department,Children's Hospital of Fudan University,Shanghai 201102,China [3]Pediatric Department,First Affiliated Hospital of Jilin University,Changchun,Jilin 130021,China [4]Neonatology Department,Guiyang Children's Hospital,Guiyang,Guizhou 550003,China [5]Neonatology Department, Zhengzhou Children's Hospital,Zhengzhou,Henan 450053,China [6]Neonatology Department, Guangzhou Children's Hospital,Guangzhou,Guangdong 510120,China [7]Neonatology Department,Gansu Provincial Women and Children's Hospital,Lanzhou,Gansu 730050,China

出　　处：《Chinese Medical Journal》2010年第20期2776-2780,共5页中华医学杂志（英文版）

基　　金：This study was supported by the grants from National Natural Science Foundation of China （No. 30711120575 and No. 30672265）. We thank Dr. Nalini Singhal （University of Calgary, Alberta, Canada） and Dr. Khalid Aziz （University of Alberta, Alberta, Canada） for careful reading and correction of the manuscript and constructive discussion.

摘　　要：Background The severity of respiratory distress was associated with neonatal prognosis. This study aimed to explore the clinical characteristics, therapeutic interventions and short-term outcomes of late preterm or term infants who required respiratory support, and compare the usage of different illness severity assessment tools.Methods Seven neonatal intensive care units in tertiary hospitals were recruited. From November 2008 to October 2009, neonates born at ≥34 weeks＇ gestational age, admitted at 〈72 hours of age, requiring continuous positive airway pressure （CPAP） or mechanical ventilation for respiratory support were enrolled. Clinical data including demographic variables, underlying disease, complications, therapeutic interventions and short-term outcomes were collected. All infants were divided into three groups by Acute care of at-risk newborns （ACoRN） Respiratory Score 〈5, 5-8, and 〉8.Results During the study period, 503 newborn late preterm or term infants required respiratory support. The mean gestational age was （36.8±2.2） weeks, mean birth weight was （2734.5±603.5） g. The majority of the neonates were male （69.4%）, late preterm （63.3%）, delivered by cesarean section （74.8%）, admitted in the first day of life （89.3%） and outborn （born at other hospitals, 76.9%）. Of the cesarean section, 51.1% were performed electively. Infants in the severe group were more mature, had the highest rate of elective cesarean section, Apgar score 〈7 at 5 minutes and resuscitated with intubation, the in-hospital mortality increased significantly. In total, 58.1% of the patients were supported with mechanical ventilation and 17.3% received high frequency oscillation. Adjunctive therapies were commonly needed.Higher rate of infants in severe group needed mechanical ventilation or high frequency oscillation, volume expansion,bicarbonate infusion or vasopressors therapy （P 〈0.05）. The incidence of complications was also increased significantly in severe group （P 〈0.Background The severity of respiratory distress was associated with neonatal prognosis. This study aimed to explore the clinical characteristics, therapeutic interventions and short-term outcomes of late preterm or term infants who required respiratory support, and compare the usage of different illness severity assessment tools.Methods Seven neonatal intensive care units in tertiary hospitals were recruited. From November 2008 to October 2009, neonates born at ≥34 weeks＇ gestational age, admitted at 〈72 hours of age, requiring continuous positive airway pressure （CPAP） or mechanical ventilation for respiratory support were enrolled. Clinical data including demographic variables, underlying disease, complications, therapeutic interventions and short-term outcomes were collected. All infants were divided into three groups by Acute care of at-risk newborns （ACoRN） Respiratory Score 〈5, 5-8, and 〉8.Results During the study period, 503 newborn late preterm or term infants required respiratory support. The mean gestational age was （36.8±2.2） weeks, mean birth weight was （2734.5±603.5） g. The majority of the neonates were male （69.4%）, late preterm （63.3%）, delivered by cesarean section （74.8%）, admitted in the first day of life （89.3%） and outborn （born at other hospitals, 76.9%）. Of the cesarean section, 51.1% were performed electively. Infants in the severe group were more mature, had the highest rate of elective cesarean section, Apgar score 〈7 at 5 minutes and resuscitated with intubation, the in-hospital mortality increased significantly. In total, 58.1% of the patients were supported with mechanical ventilation and 17.3% received high frequency oscillation. Adjunctive therapies were commonly needed.Higher rate of infants in severe group needed mechanical ventilation or high frequency oscillation, volume expansion,bicarbonate infusion or vasopressors therapy （P 〈0.05）. The incidence of complications was also increased significantly in severe group （P 〈0.

关 键 词：infant  newborn intensive care  neonatal severity of illness index respiratory distress syndrome 

分 类 号：R686[医药卫生—骨科学]