Clinical characteristics and prognosis-related factors of neonatal acute respiratory distress syndrome

Abstract

Objective To investigate the clinical characteristics of neonatal acute respiratory distress syndrome (ARDS), and the factors influencing its prognosis. Methods Clinical data of 1 018 cases suffering from respiratory failure admitted to the neonatal intensive care unit (NICU) of our hospital during the year of 2017 were collected and retrospectively analyzed. Among them, 204 cases were diagnosed as neonatal ARDS according to the Montreux definition. The clinical data of these 204 neonatal ARDS patients were retrospectively analyzed. Results ① There were 12 preterm infants (5.9%) with gestational age of 24 weeks to 27 weeks + 6 d, 49 preterm infants (24.0%) with gestational age of 28 weeks to 31 weeks + 6 d, 70 preterm infants (34.3%) with gestational age of 32 weeks to 36 weeks + 6 d, and 73 full-term infants (35.8%). The infants had an average birth weight of 2 260±898 g, with the male ratio of 62.3% (127 cases). Among them, 42 cases (20.7%) got 5 min Apgar score≤7 points. There were 94 cases (46.1%) suffering from sepsis, including 85 cases with early-onset sepsis. According to oxygen index, the 204 ARDS infants were assigned into mild (n=137, 67.2%), moderate (n=49, 24.0%) and severe (n=18, 8.8%) groups, and significant differences were seen in the ratio of non-invasive ventilation, time of assisted ventilation and length of hospital stay among the groups (P < 0.05). ② Among the 204 cases, 163 cases (79.9%) got improved or cured, and 41 cases (20.1%) were abandoned or dead. For different prognosis groups, univariate analysis found that gestational age, birth weight, and 5 min Apgar score were related to prognosis (P < 0.05). Multivariate logistic regression analysis showed that gestational age was an independent influencing factor for neonatal ARDS prognosis. Conclusion Gestational age, birth weight and 5 min Apgar score are pivotal factors for the prognosis of neonatal ARDS.

Keywords

• acute respiratory distress syndrome
• neonates
• prognosis
• oxygenation index