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【Objective】 To investigate the influencing factors of red blood cell transfusion volume for premature neonatal pneumonia and its predictive value for feeding intolerance. 【Methods】 272 infants of premature neonatal pneumonia treated with red blood cell transfusion were collected as the research objects. Red blood cell transfusion volume was investigated and its influencing factors were analyzed by multiple linear regression. Receiver operating curve (ROC) was used to analyze the predictive value of red blood cell transfusion volume on feeding intolerance in infants with premature neonatal pneumonia. 【Results】 The average red blood cell transfusion volume in infants with premature neonatal pneumonia was (76.19±26.03) mL. Multiple linear regression analysis showed that gestational age, birth weight, volume of blood collection and hemoglobin level before blood transfusion were influencing factors of red blood cell transfusion volume in infants with premature neonatal pneumonia (B=-1.930, -6.215, 1.041, -0.249, P<0.05). The incidence of feeding intolerance in infants with premature neonatal pneumonia was 19.5%. The transfusion volume of feeding intolerance group was significantly higher than that of the non-feeding intolerance group(P<0.05). ROC analysis showed that the area under curve (AUC) of red blood cell transfusion volume for predicting feeding intolerance was 0.755. 【Conclusion】 Gestational age, birth weight, volume of blood collection and hemoglobin level before blood transfusion are influencing factors of red blood cell transfusion volume in infants with premature neonatal pneumonia. The incidence of feeding intolerance in premature neonatal pneumonia is high. The red blood cell infusion volume is of good predictive value for the occurrence of feeding intolerance. Latrogenic blood loss and red blood cell transfusion volume should be minimized clinically.
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Background: Pneumonia contributes to between 7, 50,000 and 1.2 million neonatal deaths and an unknown number of stillbirths each year worldwide1. It is estimated that 3.9 million of the 10.8 million deaths in children annually worldwide occur in the first 28 days of life.2 Neonatal pneumonia can be preventable if it is diagnosed as early as possible. Early recognition and prompt management are essential for the better outcome.Aim and objective: To determine bacterial etiology of neonatal pneumonia and to study the risk factors associated with neonatal pneumonia.Methods: A prospective, descriptive study was conducted for the duration of one year from July 2014 to June 2015 in Pragna children's Hospital, a tertiary care centre, Hyderabad, Telangana, India. A total of 100 neonates were admitted in Pragna children's Hospital with the signs and symptoms of neonatal pneumonia. A detailed history was taken including age, obstetric history of the mother, detailed birth history including resuscitation details and gestational age assessment were evaluated.Results: Out of 100 cases, 39(39%) neonates were preterm babies and 61(61%) were term. Also found history of Prolonged Rupture of Membrane (PROM) in 22% cases, maternal fever in 18%, home deliveries in 14% and foul smelling liquor in 18%. Out of 100 cases, 51 (51%) cases had positive finding in Chest X-Ray for neonatal pneumonia and 57(57%) had pneumonia with septicemia. Out of 100 cases, 9% of cases are positive for Coagulase negative staphylococcus (CONS), 5% for Klebsiella pneumonia, 2% for Pseudomonas aeroginosa and the remaining 84% of the cases had no growth for any organism.Conclusions: Major predisposing factors included PROM, foul smelling liquor, maternal fever, and home deliveries. CONS was the commonest organism isolated in blood culture.
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OBJECTIVE: To evaluate the diagnostic value of lung ultrasound for neonatal pneumonia by Meta-analysis.METHODS: PubMed,Cochrane library,Embase,CNKI and Wanfang Database were searched from database establishment to September 2018 to gather articles according to the inclusion and exclusion criteria of diagnostic research. A total of 907 studies were retrieved. Eight studies were selected for analysis. QUADAS2 was used to evaluate the quality of articles included. Heterogeneity was assessed by using Q and I2 statistics. Meta-Disc 1.4 software was applied for the statistical analysis to evaluate the diagnostic value of lung ultrasound for neonatal pneumonia. RESULTS: A total of 8 articles involving 1078 cases were included. Random effect model was adopted for statistical analysis. The pooled sensitivity was0.96(95%CI:0.95-0.98);the pooled specificity was 0.98(95%CI:0.95-0.99);the pooled positive likelihood ratio was19.52(95%CI:5.00-76.15);the pooled negative likelihood ratio was 0.04(95%CI:0.01-0.16);the pooled odds ratio was 565.45(81.80-3908.58);the area under SROC was 0.9950. CONCLUSION: The sensitivity and specificity of lung ultrasound in the diagnosis of neonatal pneumonia are higher than X-ray. Considering the features of being easy,readily availability,low cost,and being free from radiological hazards,current evidence supports lung ultrasound as an imaging alternative for the diagnosis of neonatal pneumonia.
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Objective To investigate the curative effect of cephalosporins in the treatment of neonatal infectious pneumonia and the effect on intestinal microflora.MethodsA total of 124 cases of neonatal pneumonia in our hospital were divided into the cephalosporin group (40cases), the piperacillin group (38 cases) and the combined treatment group (46 cases), and 40 healthy neonates were selected as healthy group.The clinical efficacy was compared.The intestinal bacterial genus of the four groups was examined on the 5th day after treatment, including Enterobacter, Bacteroides, Enterococcus, Bifidobacterium and Lactobacillus.ResultsThe cure rates of the cephalosporin group, the piperacillin group and the combined group were 82.5%, 81.57% and 89.13%, respectively.The healing time of the above three groups was (5.3±0.2) d, (5.5±0.3) d and (5.2±0.3) d, respectively.Enterobacteriaceae, Bacteroides, Enterococcus and Lactobacillus were significantly more in the above three groups than the healthy group, and Bifidobacterium was fewer than healthy group (P<0.05).There was no significant difference between the cephalosporin group and piperacillin group.ConclusionThe curative effect of cephalosporins is similar to other antibiotics in the treatment of neonatal infectious pneumonia.The former can effectively relieve alteration of intestinal flora, combined with other drugs.Irrational use of antibiotics woll increase alteration of intestinal flora.
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Objective To explore and analyze the effect of ambroxol hydrochloride combined with budesonide inhalation in the treatment of neonatal pneumonia and intervention treatment. Methods May 2014 to March 2017, Taizhou Hospital for treatment of pneumonia in infants, a total of 100 cases of the research object, according to the different treatment methods of the infant patients into the control group and the study group, 50 cases in each group. The study group were treated with ambroxol combined with budesonide inhalation treatment methods, patients in control group were treated with budesonide inhalation treatment methods, two patients were given nursing intervention on in the process of treatment, observation and comparison of two groups of children were observed two different quality methods the therapeutic effect. Results The children of patients with treatment effect was stronger than the control group, the difference is statistically significant(P<0.05). The study of the recovery time and hospitalization time were significantly less than the control group, with statistically significant difference (P<0.05). The degree of satisfaction with nursing is significantly better than the control group(P<0.05). Conclusion The treatment method of neonatal pneumonia ambroxol combined with budesonide inhalation, and implement the corresponding nursing intervention, can effectively improve the clinical symptoms of patients, improve lung function in patients, improve the therapeutic effect, shorten the patient's symptoms disappeared time and hospitalization time, children can not only improve the standard of living of the patients, but also enhance the degree of recognition of the hospital and nursing care of patients thus, play a role in the promotion.
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Objective To observe the effect of aerosol inhalation of ambroxol combined with budesonide on neonatal pneumonia .Methods 66 infants with pneumonia treated were enrolled in this study.The patients were divided into observation group ( n =33 ) and control group ( n =33 ) according to the random number method.The treatment group were treated with ambroxol combined with budesonide and the control group were treated with budesonide.The two groups of infant lung function, clinical outcomes and blood flow were compared.Results The total effective rate (93.94%) in the observation group was significantly higher than that in the control group (45.45%), there was significant difference between the two groups (P<0.05).After treatment, FEV1 and PEF in the two groups were significantly higher than those before treatment, the observation group [(95.21 ± 7.69)%, (93.21 ±7.89)%] were significantly higher than those of the control group[(87.03 ±7.23)%, (84.55 ±7.45)%], the differences between the two groups were statistically significant (P<0.05).The OI of the two groups was significantly higher than that of the control group and the OI of the observation group was significantly higher than that of the control group.PaCO2 of the two groups decreased significantly and the PaCO2 of the observation group was significantly lower than that of the control group, the difference was statistically significant ( P<0.05 ).Conclusion The combination of ambroxol and budesonide is effective in the treatment of neonatal pneumonia.It can effectively improve the infant pulmonary function, shorten the treatment time and improve the hemodynamics of infants .
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Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia in Jiaxing,and to provide a therapy for clinical doctor to make a correct diagnosis,choose reasonable anti-biotics and avoid abuse of antibiotics.Methods Took expectoration from trachea in condition of asepsis to conduct culture and perform drug-sensitive test from 3025 cases.Results Totally 1 156 strains of aerobic bacteria were iso-lated.875 strains were gram negative bacilli(75.7%),269 strains were gram positive cocci(23.3%),and 12 strains were fungi(1.0%).Klebsiella pneumoiae,Escherichia coil,Acinetobacter baumanni,Enterobacter cloacae were com-mon in gram negative bacilli( respectively 178 cases,151 cases,87 cases,113 cases) .The proportion of the Staphylo-coccus aureus was the largest in gram positive cocci(245 cases) .The results showed that gram-negative bacilli were resistant to cefazolin, ampicillin, piperacillin and sensitive to meropenem, imipenem, piperacillin-tazuobatanna and cefoperazone-sulbactam.The drug resistance was severe of ESBL-positive.Staphylococcus aureus was resistant to penicillin, ampicillin, erythrocin, clindamycin and sensitive to linezolid, vancomycin, nitrofurantoin.Conclusion Gram-negative bacilli are the main bacteria in neonatals with infectious pneumonia.The drug resistance is severe.It is important to make a standard management and isolation.
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Objective To learn the significance of detection of high sensitive troponin T and creatine kinase isoenzyme in diagnosis of pediatric myocarditis.To provide reliable laboratory diagnosis method for the disease.Methods 23 cases of pediatric myocarditis,28 cases of viral myocarditis with capillary bronchitis and 61.cases of myocarditis with neonatal pneumonia were selected as the research objects;and 48 cases of healthy control group,55 cases of capillary bronchitis and 49 cases of neonatal pneumonia were also selected.Blood samples were collected from all the patients and healthy controls,and the levels of high sensitive serum troponin T and creatine kinase isoenzyme were also measured.Results There was no significant difference in the detection results of high sensitive troponin T and creatine kinase isoenzyme between the healthy control group,children with capillary bronchitis and neonatal pneumonia (all P ＞ 0.05);high sensitive troponin T and creatine kinase isoenzyme detection results of myocarditis,myocarditis complicated with bronchiolitis,myocarditis complicated with neonatal pneumonia were higher than those in healthy control group,the differences were statistically significant (t =13.723,6.628,10.079,9.475,17.650,15.364,all P ＜ 0.05).The abnormal rates of combined detection of children with myocarditis,myocarditis combined with capillary bronchitis,myocarditis combined with neonatal pneumonia were higher than those of single detection of high sensitive troponin T and single detection of creatine kinase isoenzyme (x2 =7.426,6.310,6.720,4.308,4.381,6.900,all P ＜0.05).The high sensitive troponin T and creatine kinase isoenzyme in the children with the age of 1-12 months and 1-3 were lower than those with the age of ＜ 1 month,the differences were statistically significant (t =3.498,4.043,4.202,4.132,all P ＜ 0.05).Conclusion The simultaneous detection of high sensitive troponin T and creatine kinase isoenzyme can be used in the diagnosis of pediatric myocarditis,with good clinical application value.
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Objective To investigate the clinical efficacy and its security on different kinds of atomization with mucosolvan and chymotrypsin in treating neonatal pneumonia.Methods Seventy-eight neonates who were diagnosed as neonatal pneumonia were divided into treatment group (n =39) and control group (n =39) by random number table method from Jul 2011 to Aug 2013 in our hospital.The control group was treated with chymotrypsin atomization,and the treatment group was treated with compression atomizing to inhale mucosolvan.The treatment effects of two groups were compared.Results Compared with the control group after treatment for 24 h,48 h,72 h,the treatment group had more significant increasing in PaO2,more decreasing in PaCO2 and more significant improvement in oxygenation index.There were statistical significances between the two groups(P ＜ 0.01).The treatment group spent shorter time in remission of symptoms,disappear of signs and hospital stay than that of the control group(P ＜ 0.05).In the treatment group,25 cases were markedly improved,9 cases were effective,5 cases were invalid.The effective rate was 87.2％.In the control group,14 cases were markedly effective,6 cases were effective,19 cases were invalid.The effective rate was 51.3％.The effective rate was significant difference between the two groups (P ＜ 0.01).The adverse drug reactions were not found in the process of treatment for two groups.Conclusion Mucosolvan atomizing inhalation has a better treatment effect than chymotrypsin.It can shorten the course of treatment,and is worth promoting the application.
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The study carried on 134 children diagnosed pneumonia immediately after hospitalization and 205 children of control group hospitalised with difference reasons in the same time. The result showed that the age of newborn pneumonia is 10 days, 26.9% of them is 7 days is 73.1%. However, 79.9% of these children were ill before hospitalization <3 days. The risque pneumonia of prematurely children is higher 1.33 times than control group. 83/134 pneumonia children has anamnesis asphyxiated when be born. The delivery time prolonger 18 hours has risque higher 1.59 times than control group. After research, the author showed some related factors direct with newborn pneumonia are: asphyxiated, amniotic fluid dirty, delivery time prolong, time of rupture of amniotic membranes long and born prematurely
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Child , Pneumonia , DiseaseABSTRACT
Study 134 neonatal pneumonia who admitted National Institute of Pediatrics from 2001 December to 2002 November. Tracheal secretions of patients were cultured for bacteria caused pneumonia and appropriate antibiotics. Results: Common bacteria caused pneumonia were bacteria gram (-), the highest was Klebsilla pneumoniae, that resisted most of common antibiotics, and well sensitised with amikacine and 3rd and 4th generation cephalosporines and tienam. S. aureus accounted for 6.38%, sensitised with vancomycine, erythromycine, oxacilline, and tienam
Subject(s)
Pneumonia , Bacteria , DiseaseABSTRACT
The study consist of 134 neonatal pneumonia who under 28 days born addmitted to The Neonatal department of National Institute of Peadiatrics from December 2001 to November 2002. The out comes showed that: Positive rate: 71.15%, negative rate: 29.85%. Common isolated bacteria were negative Gram. Ampicillin, gentamycin, chloramphenicol bactrim have resistance antibiotic. The recovered treatment result: 90.3%; mortality: 9.7% in which 61.2% are fully recovered without change other antibiotic. The average treatment duration by antibiotic:13.2%