scholarly journals Analysis of Neonatal Respiratory Distress in Neonatal Intensive Care Unit at Nepal Medical College

2018 ◽  
Vol 16 (2) ◽  
pp. 131-135
Author(s):  
Prashant Rijal ◽  
Mandira Shrestha

Background: Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit. However, studies of newborn admitted with respiratory distress in our setup are limited. This study aims to look for incidence of neonatal respiratory distress in our setup, to analyze the common causes of respiratory distress and to determine possible strategic plan needed for better clinical outcome.Methods: A cross sectional study was conducted from March 2013 to December 2014 in Nepal Medical College and Teaching Hospital. Data of all the neonates with respiratory distress admitted during this period were analyzed.Results: Total 317 (13.4%) neonates were admitted to Neonatal Intensive Care Unit during the study period.109 neonates developed respiratory distress comprising 34.3% of all Neonatal Intensive Care Unit admissions. Incidence of neonatal respiratory distress was 4.6%. The common causes of respiratory distress in our study were meconium aspiration syndrome in 21.1%, septicemia in 16.5%, transient tachypnea of newborn in 15.5%, pneumonia in 14.6%, birth asphyxia and hyaline membrane disease were in each 11.9% of the neonates. Caesarean section was the most common predisposing factor associated with the development of transient tachypnea of newborn in 82.3% newborns (p=.001). The overall mortality rate due to respiratory distress was 12.8%.Conclusions: Meconium aspiration syndrome, septicemia and hyaline membrane disease are the most important causes of respiratory distress in our setup. Good obstetric care, proper training of health care personnel in neonatal resuscitation and early recognition of potential risk factors of respiratory distress will be helpful. 

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Sunil Raja Manandhar

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.


2017 ◽  
Vol 4 (6) ◽  
pp. 2027
Author(s):  
Pushpak H. Palod ◽  
Bhagwat B. Lawate ◽  
Mahesh N. Sonar ◽  
Sneha P. Bajaj

Background: Respiratory disorders are the most frequent cause of admission for neonatal intensive care in both term and preterm infants. The clinical diagnosis of respiratory distress in a newborn is suspected if the respiratory rate is greater than 60 per minute in a quite resting baby, presence of grunting and/or there are inspiratory subcostal/intracostal retractions Signs and symptoms of respiratory distress include cyanosis, grunting, nasal flaring, retractions, tachypnea, decreased breath sounds with or without rales and/or rhonchi, and pallor. Objectives of present study were to know the clinical profile and aetiology of neonates with respiratory distress and to study the morbidity and mortality of respiratory distress in neonatal intensive care unit (NICU). And to find out the predictors of survival in the neonates admitted with respiratory distress.Methods: Study is done on 281 neonates admitted in Neonatal Intensive Care Unit (NICU) as a Prospective Cohort and Descriptive Study and Simple Random sampling is used to include neonates in the study. All the neonates included in study were subjected to the following detailed perinatal history and thorough clinical examination of newborns was done.Results: Males outnumber the females in admission. Most of the affected neonates were weighing between 1500g to 2500g (185). Out of total patients of two hundred and eighty-one, there were 35 deaths (12.5%) and 246 patients survived (87.5%). In present study most common causes for respiratory distress were respiratory distress syndrome (31.3%), neonatal septicaemia including pneumonia (28.1%), TTBN (16.7%).Conclusions: The overall survival rate was 87.5%. Male outnumber female on admissions but the survival in females was better than males. Common causes of respiratory distress in our study are RDS, Neonatal septicaemia and TTBN. As the gestation increased the survival also improved. Term neonates had better survival as compared to preterm neonates. Antenatal corticosteroid administration improved the survival. 


2017 ◽  
Vol 4 (2) ◽  
pp. 490
Author(s):  
Ankush Kommawar ◽  
Rajendra Borkar ◽  
Jayant Vagha ◽  
Bhavana Lakhkar ◽  
Rewat Meshram ◽  
...  

Background: Respiratory distress is one of the most common reasons an infant is admitted to the neonatal intensive care unit. Fifteen percent of term infants and 29% of late preterm infants admitted to the neonatal intensive care unit develop significant respiratory morbidity; this is even higher for infants born before 34 weeks ‘gestation. Certain risk factors increase the likelihood of neonatal respiratory disease. These factors include prematurity, meconium-stained amniotic fluid (MSAF), caesarean section delivery, gestational diabetes, maternal chorioamnionitis, or prenatal ultrasonographic findings, such as oligohydramnios or structural lung abnormalities. Aim of the study was to study   the, etiology and outcome of respiratory distress in newborns.Methods: The present study was conducted at the Department of Pediatrics, Acharya Vinoba Bhave Rural Hospital, Jawaharlal Nehru Medical College, Sawangi (Meghe),Wardha, Maharashtra, India. Sample size was decided on the basis of prevalence of neonatal respiratory distress in our area. It was conducted for a period of two years from 1st August 2014 to 31st July 2016.Results: maximum admissions on day 1 of life i.e. 309 (77.25%) followed by on day 2 i.e. 90 (22.50%) 231 (57.75%) were males and 169 (42.25%) were females. Male to female ratio was 1.36:1 Out of 400 children 11 were less than 1000 gms, followed by 77 (19.25%) had birth weight between 1000 g - 1499 g, 193 (48.25%) neonates had weight between 1500 g - 2499 gms and 118 (29.5%) neonates had weight between 2500 - 3499 gms and remaining 1 neonate had birth weight > 3500 grams. Out of 400 Neonates with respiratory distress, 281 (70.25%) had low birth weight and remaining 119 (29.75%) neonates had normal birth weight.Conclusions: Respiratory distress was the major cause of admission in our NICU. Caesarean section was the most common predisposing factor associated with the development of respiratory distress in neonates. Antenatal risk factors increase the incidence of RD. The most common causes of respiratory distress were TTN, RDS, MAS, and perinatal asphyxia. The common cause of death was HMD. The outcome of neonatal respiratory distress was found as: a survival rate of 78.5%, mortality rate of 21.5%.


Author(s):  
Erbu Yarci ◽  
Fuat E. Canpolat

Objective Respiratory distress presented within the first few days of life is life-threatening and common problem in the neonatal period. The aim of this study is to estimate (1) the incidence of respiratory diseases in newborns and related mortality; (2) the relationship between acute neonatal respiratory disorders rates and gestational age, birth weight, and gender; and (3) the incidence of complications associated with respiratory disturbances. Study Design Only inborn patients with gestational age between 230/7 and 416/7 weeks having respiratory distress were included in the study. The data were collected from the medical records and gestational age was based on the menstrual dating. Results There were 8,474 live births between January 1, 2013 and June 30, 2013 in our hospital. A total of 1,367 newborns were hospitalized and oxygen therapy was applied in 903 of them because of respiratory distress. An acute respiratory disorder was found to be in 10.6% (903/8,474) among all live births. Mortality was 0.76% (66/8,474). The incidence of respiratory distress syndrome was 2.8% (n = 242). The occurrence of transient tachypnea of newborn was 3.1% (n = 270). Meconium aspiration syndrome, pneumonia, congenital diaphragmatic hernia, and pulmonary maladaptation and primary persistent pulmonary hypertension rates were 0.1, 0.7, 2.2, and 0%, respectively. Overall, 553 (61%) of the 903 newborns having respiratory diseases had complications. The occurrence of necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage and air leak was 6.8, 19.8, 4.7, 24.9, and 5%, respectively. Conclusion This study offers an epidemiological perspective for respiratory disorders from a single-center level-III neonatal intensive care unit. Although number of births, premature newborns, extremely low birth weight/very low birth weight infants, and complicated pregnancies increase in years, decreasing rates of mortality and complications are very promising. As perinatal and neonatal cares are getting better in every day, we think that more promising results can be achieved over the coming years. Key Points


2020 ◽  
Vol 7 (1) ◽  
pp. 117-120
Author(s):  
Sitaram Shrestha

Neonatal period is a vulnerable period of life. In Nepal, most common causes of newborn admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis. This study explores the diseases with which 131 neonates were admitted from emergency department. Sepsis was the main cause of admission, followed by pneumonia.


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