Respiratory distress in newborn infants in Western Switzerland

Lagae, Donatienne; Schuler-Barazzoni, Mirjam; Ungarelli-McEvoy, Caitriona; Diaw, Corinne Stadelmann; Roth‐Kleiner, Matthias

doi:10.1080/14767058.2019.1678131

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…Prematurity as the primary diagnosis contributed to 33.9% of neonatal deaths, which is higher than prior Guinean and global studies reported and can be explained by the selection bias of transferred patients to the INSE, as the only structure caring for LBW and VLBW infants [ 9 , 10 , 38 , 39 ]. Premature newborns are highly susceptible to infections, quickly develop severe hypothermia, and often suffer from respiratory distress due to surfactant deficiency and lung immaturity [ 40 , 41 ] The main reasons for death in premature infants in a similar setting in Ethiopia were found to be respiratory distress syndrome, infections, and BA [ 42 ]. We confirmed in this study that the need for oxygen therapy doubled the risk of death as the outcome.…”

Section: Discussionmentioning

confidence: 99%

“Assessing Today for a Better Tomorrow”: An observational cohort study about quality of care, mortality and morbidity among newborn infants admitted to neonatal intensive care in Guinea

Alves

N’fanly²,

Diallo³

et al. 2021

PLoS ONE

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Background Neonatal mortality in Guinea accounts for about 30% of all fatalities in children younger than five years. Countrywide, specialized neonatal intensive care is provided in one single clinic with markedly limited resources. To implement targeted measures, prospective data on patient characteristics and factors of neonatal death are needed. Objective To determine the rates of morbidity and mortality, to describe clinical characteristics of admitted newborns requiring intensive care, to assess the quality of disease management, and to identify factors contributing to neonatal mortality. Methods Prospective observational cohort study of newborns admitted to the hospital between mid-February and mid-March 2019 after birth in other institutions. Data were collected on maternal/prenatal history, delivery, and in-hospital care via convenience sampling. Associations of patient characteristics with in-hospital death were assessed using cause-specific Cox proportional-hazards models. Results Half of the 168 admitted newborns underwent postnatal cardiopulmonary resuscitation. Reasons for admission included respiratory distress (49.4%), poor postnatal adaptation (45.8%), prematurity (46.2%), and infections (37.1%). 101 newborns (61.2%) arrived in serious/critical general condition; 90 children (53.9%) showed clinical signs of neurological damage. Quality of care was poor: Only 59.4% of the 64 newborns admitted with hypothermia were externally heated; likewise, 57.1% of 45 jaundiced infants did not receive phototherapy. Death occurred in 56 children (33.3%) due to birth asphyxia (42.9%), prematurity (33.9%), and sepsis (12.5%). Newborns in serious/critical general condition at admission had about a fivefold higher hazard to die than those admitted in good condition (HR 5.21 95%-CI 2.42–11.25, p = <0.0001). Hypothermia at admission was also associated with a higher hazard of death (HR 2.00, 95%-CI 1.10–3.65, p = 0.023). Conclusion Neonatal mortality was strikingly high. Birth asphyxia, prematurity, and infection accounted for 89.3% of death, aggravated by poor quality of in-hospital care. Children with serious general condition at admission had poor chances of survival. The whole concept of perinatal care in Guinea requires reconsideration.

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Section: Discussionmentioning

confidence: 99%

“Assessing Today for a Better Tomorrow”: An observational cohort study about quality of care, mortality and morbidity among newborn infants admitted to neonatal intensive care in Guinea

Alves

N’fanly²,

Diallo³

et al. 2021

PLoS ONE

Self Cite

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“…RD is de ned as the presence of at least two clinical symptoms for a minimum duration of 15 minutes, which may include tachypnea (respiratory rate > 60/min), subcostal and/or intercostal retractions, expiratory grunting, nasal aring, and central cyanosis in room air [6]. A prospective study conducted in Switzerland reported that hospitalized neonates with GA ≥ 32 weeks accounted for 85.4% of all neonates with RD [7]. In the neonatal intensive care unit (NICU), RD led to hospitalization for 28.8% of late preterm infants and 15.6% of term infants [5].…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

High-flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP) vs nasal intermittent positive pressure ventilation (NIPPV) as primary respiratory support in infants of ≥32 weeks gestational age (GA): study protocol for a three-arm multi-center randomized controlled trial

Zhou¹,

Xiong²,

Tanida³

et al. 2023

Preprint

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Background Health problems in neonates with gestational age (GA) ≥ 32 weeks remain a major medical concern. Respiratory distress (RD) is one of the common reasons for admission of neonates with GA ≥ 32 weeks. Noninvasive ventilation (NIV) represents a crucial approach to treat RD, and currently, the most used NIV modes in neonatal intensive care unit include high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), and nasal intermittent positive pressure ventilation (NIPPV). Although extensive evidence supports the use of NIPPV in neonates with a GA < 32 weeks, limited data exist regarding its effectiveness in neonates with GA ≥ 32 weeks. Therefore, the aim of this study is to compare the clinical efficacy of HFNC, CPAP, and NIPPV as primary NIV in neonates with GA ≥ 32 weeks who experience RD.Methods This trial is designed as an assessor-blinded, three-arm, multi-center, parallel, randomized controlled trial, conducted in neonates ≥ 32 weeks’ GA requiring primary NIV in the first 24h of life. The neonates will be randomly assigned to one of three groups: HFNC, CPAP or NIPPV group. The effectiveness, safety and comfort of NIV will be evaluated. The primary outcome is the occurrence of treatment failure within 72h after enrollment. Secondary outcomes include death before discharge, surfactant treatment within 72h after randomization, duration of both noninvasive and invasive mechanical ventilation, duration of oxygen therapy, bronchopulmonary dysplasia, time to achieve full enteral nutrition, necrotizing enterocolitis, duration of admission, cost of admission, air leak syndrome, nasal trauma, and comfort score.Discussion Currently, there is a paucity of data regarding the utilization of NIPPV in neonates with GA ≥ 32 weeks. This study will provide clinical evidence for the development of respiratory treatment strategies in neonates at GA ≥ 32 weeks with RD, with the aim of minimizing the incidence of tracheal intubation and reducing the complications associated with NIV.Trial registration: Chinese Clinical Trial Registry: ChiCTR2300069192. Registered on March 9, 2023, https://www.chictr.org.cn/showproj.html?proj=171491.

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“…RD is defined as the presence of at least two clinical symptoms for a minimum duration of 15 min, which may include tachypnea (respiratory rate > 60/min), subcostal and/or intercostal retractions, expiratory grunting, nasal flaring, and central cyanosis in room air [ 6 ]. A prospective study conducted in Switzerland reported that hospitalized neonates with GA ≥ 32 weeks accounted for 85.4% of all neonates with RD [ 7 ]. In the neonatal intensive care unit (NICU), RD led to hospitalization for 28.8% of late preterm infants and 15.6% of term infants [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP) vs nasal intermittent positive pressure ventilation as primary respiratory support in infants of ≥ 32 weeks gestational age (GA): study protocol for a three-arm multi-center randomized controlled trial

Zhou,

Xiong,

Tang

et al. 2023

Trials

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Background Health problems in neonates with gestational age (GA) ≥ 32 weeks remain a major medical concern. Respiratory distress (RD) is one of the common reasons for admission of neonates with GA ≥ 32 weeks. Noninvasive ventilation (NIV) represents a crucial approach to treat RD, and currently, the most used NIV modes in neonatal intensive care unit include high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), and nasal intermittent positive pressure ventilation. Although extensive evidence supports the use of NIPPV in neonates with a GA < 32 weeks, limited data exist regarding its effectiveness in neonates with GA ≥ 32 weeks. Therefore, the aim of this study is to compare the clinical efficacy of HFNC, CPAP, and NIPPV as primary NIV in neonates with GA ≥ 32 weeks who experience RD. Methods This trial is designed as an assessor-blinded, three-arm, multi-center, parallel, randomized controlled trial, conducted in neonates ≥ 32 weeks’ GA requiring primary NIV in the first 24 h of life. The neonates will be randomly assigned to one of three groups: HFNC, CPAP or NIPPV group. The effectiveness, safety and comfort of NIV will be evaluated. The primary outcome is the occurrence of treatment failure within 72 h after enrollment. Secondary outcomes include death before discharge, surfactant treatment within 72 h after randomization, duration of both noninvasive and invasive mechanical ventilation, duration of oxygen therapy, bronchopulmonary dysplasia, time to achieve full enteral nutrition, necrotizing enterocolitis, duration of admission, cost of admission, air leak syndrome, nasal trauma, and comfort score. Discussion Currently, there is a paucity of data regarding the utilization of NIPPV in neonates with GA ≥ 32 weeks. This study will provide clinical evidence for the development of respiratory treatment strategies in neonates at GA ≥ 32 weeks with RD, with the aim of minimizing the incidence of tracheal intubation and reducing the complications associated with NIV. Trial registration Chinese Clinical Trial Registry: ChiCTR2300069192. Registered on March 9, 2023, https://www.chictr.org.cn/showproj.html?proj=171491.

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Respiratory distress in newborn infants in Western Switzerland

Cited by 7 publications

References 22 publications

“Assessing Today for a Better Tomorrow”: An observational cohort study about quality of care, mortality and morbidity among newborn infants admitted to neonatal intensive care in Guinea

“Assessing Today for a Better Tomorrow”: An observational cohort study about quality of care, mortality and morbidity among newborn infants admitted to neonatal intensive care in Guinea

High-flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP) vs nasal intermittent positive pressure ventilation (NIPPV) as primary respiratory support in infants of ≥32 weeks gestational age (GA): study protocol for a three-arm multi-center randomized controlled trial

High-flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP) vs nasal intermittent positive pressure ventilation as primary respiratory support in infants of ≥ 32 weeks gestational age (GA): study protocol for a three-arm multi-center randomized controlled trial

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