ABSTRACT
A retrospective analysis of neonates admitted for ventilatory support to the neonatal intensive care unit at the University Hospital of the West Indies between August 2001 and December 2004 was conducted. One hundred and thirty-eight neonates fulfilled criteria for admission into the study. Ninety-eight (71) were inborn, 88 (64) survived and 50 (36) died. The median age at death was 72 hours and 72of non-survivors died within one week of life. The main reasons for admission into the unit were respiratory distress syndrome 87(63), followed by hypoxic ischaemic encephalopathy 15 (11), surgical indications 13 (9) and meconium aspiration syndrome 11 (8). Babies with meconium aspiration syndrome and surgical problems had the best survival 82and 85respectively. Survival rates increased with increasing birthweight and gestational age. The most common complication seen was air leaks. The judicious use of neonatal intensive care measures in a developing country can result in a reduction of morbidity and mortality. However to maximize on benefits versus cost in an atmosphere of budgetary constraint evidence based management policies and protocols must be developed and implemented.
Se llevó a cabo un análisis retrospectivo de recién nacidos ingresados para recibir soporte respiratorio en la Unidad de Cuidados Intensivos Neonatales (UCIN) del Hospital Universitario de West Indies, entre agosto de 2001 y diciembre de 2004. Ciento treinta y ocho neonatos cumplieron con los criterios de admisión al estudio. Noventa y ocho (71%) fueron pacientes inborn, es decir, nacidos en el mismo hospital, 88 (64%) sobrevivieron y 50 (36%) fallecieron. La edad promedio de muerte fue 72 horas y el 72% de los que no sobrevivieron murió en el transcurso de la primera semana de vida. Las razones principales de ingreso a la unidad fueron el síndrome de insuficiencia respiratoria 87(63%), seguido por la encefalopatía hipóxica isquémica 15 (11%), indicaciones quirúrgicas 13 (9%) y el síndrome de aspiración de meconio 11 (8%). Los bebés con síndrome de aspiración meconial y problemas quirúrgicos, tuvieron los mejores índices de supervivencia 82% y 85% respectivamente. Las tasas de supervivencia experimentaron un incremento proporcional al aumento del peso al nacer y la edad gestacional. La complicación más comúnmente observable fue el escape de aire. El uso juicioso de medidas en el cuidado intensivo neonatal puede traducirse en una reducción de la morbilidad y la mortalidad. Sin embargo, a fin de maximizar los beneficios frente a los costos en una atmósfera de limitaciones presupuestarias, se hace indispensable implementar y desarrollar políticas y protocolos de administración basados en evidencias.
Subject(s)
Humans , Male , Female , Infant, Newborn , Hospitals, University , Intensive Care Units, Neonatal , Patient Admission , Retrospective Studies , Hypoxia-Ischemia, Brain/mortality , Hypoxia-Ischemia, Brain/therapy , Gestational Age , Hospital Mortality , Infant Mortality , Birth Weight , Surgical Procedures, Operative/mortality , Respiration, Artificial , Meconium Aspiration Syndrome/mortality , Meconium Aspiration Syndrome/therapy , Respiratory Distress Syndrome, Newborn/mortality , Respiratory Distress Syndrome, Newborn/therapy , West IndiesABSTRACT
To evaluate the causes and risk factors of neonatal mortality, in a non-tertiary district hospital nursery. Descriptive study. This study was carried out in the Neonatal Unit of Social Security Hospital Muzuffar Garh, Pakistan from 1st May 2004 to 30th April 2005. All newborns admitted in the nursery during study period were counted and the expired ones were evaluated in detail for the cause of death. A total of 410 neonates were admitted during study period, 53.65% were male and 46.35 females. 47.22% were admitted within 1st 24 hours of their life, and 61.66% within 72 hours of birth. 56.66% of the expired neonates were low birth weight. Neonatal sepsis being the commonest cause of death [44%], 35% being of EOS and 65% cases of LOS. 2"d commonest cause of neonatal death was birth asphyxia [22%] and the third commonest cause was prematurity [19%] with its complications. Other causes of neonatal mortality were neonatal jau ndice [2.77%], meconium aspiration syndrome [1.66%], hyaline membrane disease [6.66%], neural tube defects [1.11%] and congenital heart disease [1.66%]. Many babies had more than one of the above said causes. Neonatal sepsis, birth asphyxia and prematurity are the major killers in nurseries