The Clinical Comparative Study Of Neonatal Respiratory Failure In Full-term And Premature Infants Required Mechanical Ventilation

Objective:to study the incidence, therapy and outcome of neonatal respiratory failure in full-term and premature infants required mechanical ventilation. To analyze the characteristic of each group, improve the NRF remedy level in the future.Method:The 151 NRF infants who were admitted to the neonatal intensive care unit (NICU) of the Childrens Hospital of Qing Dao between January 2008 and December 2008 were divided into full-term infants group (n=56), late preterm infants (n=30), non-late preterm group (n=65). Design of two forms, one is "basic information sheet of neonatal respiratory failure", to record prenatal history, health condition of mother, status of infants and problems at delivery; primary disease, respiratory care, complications, prognosis and disease burden. Another is "assisted ventilation form of neonatal respiratory failure", recorded ventilation mode, ventilation parameters (FiO2, PIP, MAP, PEEP, and respiratory rate RR), arterial blood gas and percutaneous oxygen saturation (TcSO2). And to investigate the number of patients in 2008.Result:①A total of 1936 hospitalized newborns were enrolled, of which 838 cases of full term infants,396 cases of late preterm infants,702 cases of non-late preterm infants.151 patients developed NRF in 2008, including full-term infants 56 cases, late preterm infants 30cases, non-late preterm 65 cases, the composition of their respective ratios were 6.7%,7.6%,9.3%. There was no significant difference among the three.②The cause of NRF:full term infants were Pulmonary Infection (37.5%), Amniotic Fluid Aspiration Pneumonitis (17.9%); late preterm infants were Pulmonary Infection (43.3%), Respiratory Distress Syndrome (40%); non-late preterm infants were Respiratory Distress Syndrome (64.6%), Pulmonary Infection (9.2%), Apnea (9.2%).③The main ventilation mode is conventional mechanical ventilation of all the three groups, there is no significant difference among the threegroups. Pulmonary Surfactant was mainly used for late preterm children with severe RDS, there were significant difference between use and unuse Pulmonary Surfactant.④Full-term infants with NRF:cured, abandon treatment and mortality rates were 57.1%,42.9% and 0%; late preterm infants group were 80%,16.7%, 3.3%; non-late preterm group were 60%,33.8%,6.2%. There was significant difference between full-term infants and late preterm (P=0.034); There was no significant difference between full-term infants and non-late preterm (P=0.75); There was no significant difference between late preterm infants and non-late preterm (P=0.055).⑤The incidences of major complicated acquired pulmonary infection, air leak and pulmonary hemorrhage, were 5.4%,5.4%,5.4% in full term infants; in late preterm infants air leak, acquired pulmonary infection, Patent Ductus Arteriosus were 16.7%,13.3%,6.7% respectively; in non-late preterm infants acquired pulmonary infection, intraventricular Hemorrhage were 13.8%,6.2% respectively. There were no significant difference among the three group in the major complications.Conclusion①The incidence of NRF in our hospital was 7.8%, lower than that reported in china; There were no significant difference among the three group in the incidence of NRF.②The common complication in three groups were difference, Pulmonary Infection, Amniotic Fluid Aspiration Pneumonitis were the common complication in full term infants, Pulmonary Infection and Respiratory Distress Syndrome were the common complication in late preterm infants, non-late preterm infants were Respiratory Distress Syndrome, Pulmonary Infection and Apnea.③The main ventilation mode is conventional mechanical ventilation of all the three groups, the duration of ventilation is similar, mechanical ventilation can improve oxygenation and dropped hyercarbia remarkably. Pulmonary Surfactant was mainly used for non-late preterm infants with severe RDS treatment and has good effects on NRDS.④The prognosis of late preterm infants compared with full-term children is good, there were no significant difference between full term infants and late preterm infants, late preterm infants and non-late preterm infants.⑤Acquired pulmonary infection as its most common complications.