Application and prospect of neonatal critical illness score in China / 中国小儿急救医学

Neonatal critical illness score(NCIS) has been published for over 20 years in China and has played an active role in critical neonatal transport, illness severity assessment, and prognosis evaluation.However, there are still some limitations in the scoring system with the development of medical technology, such as failure to include crucial perinatal information, unable to quantify single indicators, difficulty in obtaining PaO 2 without oxygen inhalation, complex evaluation indicators, long evaluation time and data was difficult for scientific research, etc.Therefore, it is necessary to update and simplify it for the clinical treatment and scientific study of critically ill newborns.This review summarized NCIS application in China and compared it with foreign neonatal critical scores such as score for neonatal acute physiology, clinical risk index for babies, etc.Combined with the rising technology of artificial intelligence and deep learning in recent years, it was more straightforward and optimized to enhance its accuracy and applicability, which was aimed to play a more active role in the treatment of critical newborns and scientific research.

Application and research progress of SNAP-Ⅱ, SNAPPE-Ⅱ and NCIS / 国际儿科学杂志

The neonatal critical illness scoring system is widely used to assess the severity of neonatal disease, serious complications, neonatal mortality risk, long-term prognosis, and guide transport.At present, the scores widely used at home and abroad include clinical risk index for babies(CRIB), clinical risk index for babies Ⅱ(CRIB-Ⅱ), score for neonatal acute physiology(SNAP), score for neonatal acute physiology Ⅱ(SNAP-Ⅱ), score for neonatal acute physiology, perinatal extension, version Ⅱ(SNAPPE-Ⅱ), and neonatal critical illness score(NCIS), etc.Although there are many neonatal critical illness scoring systems, there is no recognized and ideal score, the most suitable score for assessing the severity of neonatal disease.This paper reviews the application and research progress of the three scoring systems SNAP-Ⅱ, SNAPPE-Ⅱ and NCIS.

Pertinence of score for neonatal acute physiology-II to prognosticate mortality and organ dysfunction in neonatal sepsis

INTRODUCTION:The present investigation was undertaken to correlation between mortality and morbidity (organ dysfunction [OD]) and score for neonatal acute physiology-II (SNAP-II).MATERIALS AND METHODS:A prospective investigation of newborns neonates, a total 157 neonates 82 male (52.2%), female 75 (47.8%) were enrolled and disunited into four groups according to gestational age: 28 to 30 weeks (G1), 31 to 33 (G2) 34 to 36 weeks (G3) and >37 weeks (G4) variables analyzed were SNAP II.RESULTS AND DISCUSSION:The receiver operating characteristic curve for SNAP-II score and death is more predictive in correlation to OD (area under curve of death is 0.776 as compared to 0.553 for OD). The sensitivity, specificity, positive predictive value, and negative predictive value of SNAP-II score with mortality (outcome) were 42.8%, 100%, 100%, and 82.3%, respectively.CONCLUSION:The SNAP-II revealed efficient to fantabulous ?40 can prognosticate OD and death when applied on admission to neonates with sepsis.

Risk factors of bronchopulmonary dysplasia in preterm infants and predictive value of Score for Neonatal Acute Physiology on incidence of bronchopulmonary dysplasia / 中华实用儿科临床杂志

Objective To investigate the risk factors of bronchopulmonary dysplasia (BPD) in preterm infants,and to explore the clinical application value of Score for Neonatal Acute Physiology(SNAP) in predicting the development of BPD.Methods The clinical and laboratory data of 202 premature infants with gestational age ＜ 35 weeks were reviewed.The premature infants were divided into BPD group and non-BPD group,the SNAP values for each infant during the first 24 hours of admission were calculated,the risk factors of BPD were analyzed,and the relationship between SNAP and the development of BPD was analyzed.Results There were significant differences in gestational age,birth weight and 5 min Apgar score,serum albumin between BPD group and non-BPD group(all P ＜0.05).The incidences of respiratory distress syndrome,apnea of prematurity,respiratory failure,hospital-acquired infection,anemia,patent ductus arteriosus,brain damage in BPD group were significantly higher than those in non-BPD group (all P ＜0.05).In addition,compared with non-BPD group,the times and duration of mechanical ventilation and oxygen therapy were longer in BPD group(all P ＜ 0.05).Multivariate Logistic regression revealed that gestational age,SNAP,hospitalacquired infection,and apnea of prematurity were independent risk factors of BPD (all P ＜ 0.05).The sensitivity of the SNAP was 88.6％ in predicting the development of BPD.Conclusions The development of BPD in premature infants is related with multiple factors,which provide useful information for further research on BPD.In addition,the SNAP values in premature infants can be used to predict the development of BPD.

Scores of SNAP and SNAP Variants Indices for Evaluation of Acute Severity in Newborn Infants

PURPOSE: The score for neonatal acute physiology (SNAP) based on physiologic derangements, is applied to variable fields including morbidity as well as mortality estimate. We evaluate the clinical usefulness of SNAP and SNAP variants for neonatal acute severity and mortality. METHODS: Twenty-one neonates were evaluated the SNAP, SNAP-PE, SNAP-II, and SNAPPE-II, who survived more than 24 hours in Neonatal Intensive Care Unit in Department of Pediatrics, Kyunghee University from July 2003 to December 2004. A study group included 21 neonates as death group and a control group matched for gestational age and birth weight. We analyzed the differences of clinical usefulness of SNAP and SNAP variants indices between the two groups. RESULTS: 1) SNAP:The scores were ranged 2-18 (median 6.5) in survival group and 9-31 (median 13.0) in death group. 2) SNAP-PE:The scores were ranged 2-48 (median 16.5) in survival group and 23-75 (median 32.0) in death group. 3) SNAP-II:The scores were ranged 0-16 (median 10.5) in survival group and 10-62 (median 21.0) in death group. 4) SNAPPE-II:The scores were ranged 0-45 (median 24.5) in survival group and 35-109 (median 44.0) in death group. The median values were higher in those who were died:SNAP<0.05 (P-value), SNAP-PE<0.01, SNAP-II<0.01, SNAPPE-II<0.01 showing the significant differences. CONCLUSION: The study shows that SNAP and SNAP variables are useful for the evaluation of acute severity and excellent predictors of neonatal survival. They would help the management of neonatal intensive care unit.

Analysis of Correlative Factors of Neonatal Stress Ulcer Prognosis / 实用儿科临床杂志

Objective To analyze the correlative factors of prognosis of neonatal stress-induced ulcer bleeding.Methods Fifty-four cases of NICU admitted stress-induced ulcer bleeding newborns were divided into mild group and severe group according to bleeding endurance,transfusion requirement,and clinical turnover.Compared with gender,gestational age,birth weight,and score for neonatal acute physiology(SNAP) Ⅱ and score for neonatal acute physiologyⅡ perinatal extension(SNAP-PE) Ⅱ of two groups.Results Based on the output of SPSS statistical package,the SNAP Ⅱand SNAP-PE Ⅱ had a significant deviation between two subgroups((?~2=)15.207,10.311 all P

Previsão da mortalidade neonatal entre recém-nascidos de baixo peso internados na UTI neonatal do Hospital Estadual Adão Pereira Nunes / Predicting neonatal mortality among infants of low birth weight neonatal ICU State Hospital Adam Pereira Nunes

O desenvolvimento do suporte intensivo para recém-nascidos de baixo peso ao nascimento vem introduzindo ao longo do tempo, escores de predição de mortalidade, baseados na análises da gravidade inicial destes pacientes...Uma vez que o peso de nascimento por si só não discrimina quais os fatores que determinarão o óbito entre pacientes em uma mesma faixa de peso, a aplicação dos escores se faz necessária para estabelecer a gravidade dos pacientes. Sendo assim, estes escores só devem ser utilizados para estudos populacionais e comparações entre serviços e não como instrumento para decidir condutas terapêuticas individualmente, simplesmente baseado em um escore inicial alto, o qual eleva o risco de mortalidade.