Predictors of respiratory distress syndrome, sepsis and mortality among preterm neonates admitted to neonatal intensive care unit in northern Ethiopia

2021 ◽  
Author(s):  
Gdiom Gebreheat ◽  
Beyene Tadesse ◽  
Hirut Teame
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Preterm Neonates ◽  
Northern Ethiopia

scholarly journals The Time to Initiate Trophic Feeding and Its Predictors Among Preterm Neonate Admitted to Neonatal Intensive Care Unit, Multicenter Study, Northwest Ethiopia, 2020.

2021 ◽  
Author(s):  
Daniel Adimasu ◽  
Yilikal Tafere ◽  
Teodros Eshetie ◽  
Bekalu Endalew ◽  
Ermias Abebaw ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Perinatal Asphyxia ◽  
Hemodynamic Instability ◽  
Preterm Neonates ◽  
Trophic Feeding

Abstract Background: Trophic feeding is a small volume, hypo-caloric feeding, gut priming or minimal enteral feeding acclimate the immature gut of enteral fasting preterm neonates. Delayed starting of trophic feeding had resulted in short and long-term physical and neurological sequels. The current study aimed to assess time to initiate trophic feeding and its predictors among preterm neonates admitted in the neonatal intensive care unit of Debre Markos, Felege Hiwot, and Tibebe Ghion comprehensive specialized hospitals.Methods: An institutional-based prospective follow-up study was conducted among 210 neonates. The data were collected with interview and chart review, entered into Epi data 3.1 and exported to Stata 14.1 for analysis. Multivariable Cox regression models were fitted to identify predictors of time to initiate trophic feeding. Result: A total of 210 neonates were followed for 10136 person-hours of risk time and 191 (90.95%) of neonates were started trophic feeding. The overall incidence of starting trophic feeding was 2 per 100 (95% CI: 2, 2.2) person-hours observations. The median survival time was 42 hours (95% CI: 36, 48). APGAR- score at first minute <7 (AHR: 0.6, 95% CI: 0.44, 0.82), gestational age of <34 weeks (AHR: 0.69, 95% CI: 0.5, 0.94), presence of respiratory distress syndrome (AHR: 0.5, 95% CI: 0.36, 0.68), presence of hemodynamic instability (AHR: 0.37, 95% CI: 0.24, 0.57), presence of perinatal asphyxia (AHR: 0.63, 95% CI: 0.44, 0.89), cesarean section delivery (AHR: 0.63, 95% CI: 0.44, 89) and being delivered within the study hospitals (AHR: 0.54, 95% CI: 0.39, 0.74) were found to be statistically significant predictors of time to initiate trophic feeding.Conclusion: There was a significant delay to initiate trophic feeding in the studied hospitals. Gestational age of below 34 weeks, APGAR-score of less than seven, out-born delivery, cesarean delivery, presence of respiratory distress syndrome; perinatal asphyxia, and hemodynamic instability were predictors of delay in starting of trophic feeding. Standardized feeding guideline has to be implemented to overcome delays in enteral feeding initiation.

scholarly journals The role of lung ultrasound in preterm neonates with respiratory distress in neonatal intensive care unit

2021 ◽  
Vol 8 (8) ◽  
pp. 284-288
Author(s):  
Sidhant Swarup ◽  
Rakesh Panigrahi ◽  
Suryakanta Swain ◽  
Hemant Agrawal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Preterm Neonates ◽  
Point Of Care Ultrasound

Introduction: Up to 29% of late preterm babies suffer from respiratory distress due to which they need to be admitted to neonatal intensive care unit (NICU). Point-of-care ultrasound is a useful tool in critical neonate care, providing valuable information without any risk of ionizing radiation to the newborn. Materials and Method: This mono-centric, descriptive, and prospective study was conducted in NICU. Preterm newborns of less than 36 weeks with respiratory distress at birth on non-invasive ventilation were recruited. A lung ultrasound was performed at first 12 h of life and followed till their discharge. Main outcomes need for surfactant treatment. Results: Sixty preterm infants (median gestational age: 29 weeks) were recruited. Newborn in the surfactant group requiring ultrasound and intervention was significantly higher than in no surfactant group (p<0.0001). In 15 newborns who received surfactant, the first dose was administered at a median age of 4.5 h. In 13 of these 15 newborns, the lung ultrasound scan was subsequently repeated an average of 2 h (Standard deviation or SD: 2) On average, the second dose of surfactant was administered at 24 h of life (SD: 9). Conclusion: Early lung ultrasound in preterm infants with respiratory distress appears to be a useful tool with no adverse effects for the patient. It allows a better assessment of respiratory distress by detecting patients with a greater risk of requiring surfactant or mechanical ventilation, even before oxygenation criteria.

scholarly journals Assistência fisioterapêutica em prematuros com Síndrome do Desconforto Respiratório: uma revisão de literatura

Scire Salutis ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 43-53
Author(s):  
Simone Amancio Teles ◽  
Marineth Ferreira de Carvalho Teixeira ◽  
Daniela Maristane Vieira Lopes Maciel
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Physical Therapy ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Terapia Intensiva

A Síndrome do Desconforto Respiratório (SDR) é um distúrbio que acomete principalmente os recém-nascidos prematuros pela imaturidade pulmonar, resultante da deficiência ou inativação do surfactante. O surfactante é uma substância lipoprotéica produzida pelas células pneumócitos tipo II e armazenado nos corpos lamelares para, posteriormente, ser liberado no espaço alveolar, sintetizado a partir da 20º semana de gestação, com pico de produção por volta da 35º semana. A função do surfactante é diminuir a tensão superficial dos alvéolos, evitando o colabamento na expiração. Quanto menor a idade gestacional de nascimento, maior o risco de desenvolver a SDR. A prematuridade e a imaturidade do sistema respiratório levam à maior necessidade de suporte ventilatório invasivo, oxigenioterapia, assistência fisioterapêutica e internação na unidade de terapia intensiva neonatal. A fisioterapia respiratória tem papel importante na manutenção da permeabilidade das vias aéreas, prevenção de complicações respiratórias, promoção da higiene brônquica, otimização da reexpansão pulmonar, posicionamento adequado e vigilância nos ajustes dos parâmetros da ventilação mecânica invasiva e não invasiva. Este estudo tem o objetivo de realizar uma revisão bibliográfica para identificar as estratégias terapêuticas respiratórias utilizadas pelo fisioterapeuta na assistência ao recém-nascido prematuro com Síndrome do Desconforto Respiratório. Para este fim, fizemos um levantamento de artigos científicos em bases de dados eletrônicos como SciELO, LILACS, Google Acadêmico e PubMed, através dos cognatos ‘Síndrome do Desconforto Respiratório’, ‘prematuros’, ‘unidade de terapia intensiva neonatal’, ‘fisioterapia’ e ‘ventilação mecânica’, e seus correlatos em inglês ‘Respiratory Distress Syndrome’, ‘premature infants’, ‘neonatal intensive care unit’, e ‘physical therapy and mechanical ventilation’. A assistência fisioterapêutica a neonatos prematuros com SDR na UTIN é imprescindível para o sucesso da terapêutica e melhora progressiva da função pulmonar até a alta. O fisioterapeuta deve exercer um plano de tratamento integral e humanizado indo desde o ajuste ventilatório invasivo e não invasivo a execução de manobras terapêuticas, posicionamento e cuidados com a ocorrência de sequelas como hemorragia intraperiventricular e displasia broncopulmonar que podem comprometer o desenvolvimento neuropsicomotor e qualidade de vida após alta hospitalar.

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