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

Mandira Shrestha,Prashant Rijal

doi:10.3126/jnhrc.v16i2.20297

Abstract

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. 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. 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%. 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.

Highlights

Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit (NICU).1 15.0% of term babies, 29.0% of late preterm and even a higher proportion of newborns born prior to 34 weeks of gestation develop significant respiratory morbidity.[2]
Maternal risk factors like PROM, maternal fever, foul smelling liquor, hypertension, and diabetes mellitus were present in Meconium Aspiration Syndrome (MAS), septicemia, Tachypnea of the Newborn (TTN), pneumonia, and Hyaline Membrane Disease (HMD)(Table 2)
Congenital heart disease was the cause for respiratory distress in 6.4% cases (Table 1).Of all clinical signs and symptoms tachypnea, was the most common finding for the diagnosis of neonatal respiratory distress found in 87.1% neonates

Summary

Introduction

Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit (NICU).1 15.0% of term babies, 29.0% of late preterm and even a higher proportion of newborns born prior to 34 weeks of gestation develop significant respiratory morbidity.[2]. Case fatality for newborns with hyaline membrane disease is 20.0-40.0% in developed countries and 50.0-75.0% in India It ranges from 14.3% to 37.0% for meconium aspiration related respiratory distress deaths.[4] Most of the causes of neonatal morbidity and mortality are preventable.[5] Regardless of the cause, if not recognized early, respiratory distress can escalate to respiratory failure and cardiopulmonary arrest. Respiratory distress is one of the most common reasons for admission in Neonatal Intensive Care Unit. 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

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Methods

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Discussion

Conclusion