ABSTRACT
OBJECTIVE: To analyze the incidence, risk factors, major morbidity, mortality and resource employment in very low birth weight infants (< 1500 g) with respiratory distress syndrome (RDS). METHODS: Descriptive study using prospectively obtained on-line information from a data base of 20 units belonging to the South American Neocosur Network. A total of 5991 VLBW infants were registered during years 2002-2007. RESULTS: The mean gestacional age was 29.1 weeks (95% CI 29.06-29.21) and the mean of birth weight was 1100.5 g (95% CI 1093.79-1107.37). The global incidence of RDS was 74% (95% CI 73-75). Antenatal steroids were administered to 73% of this population. The main risk factor was lower gestational age (p< 0.001); where as prenatal steroids (OR: 0.59; 95% CI 0.49-0.72), female gender (OR: 0.77; 95% CI 0.67-0.89) and premature rupture of membranes (OR: 0.81; 95% CI 0.68-0.96) were protective factors. Antenatal steroids was also associated with a decrease in mortality in those infants that presented with RDS (OR: 0.40; 95% CI 0.34-0.47). Use of resources was higher in the group with RDS, with a greater use of surfactant (74.3% vs. 7.3%, p< 0.001), mechanical ventilation (82.1% vs. 23.8%, p< 0.001), and more days of oxygen (median of 8 vs. 1 day, p< 0.001) and hospitalization (median of 61 vs. 45 days, p< 0.001). RDS was associated to an increase risk in the incidence of ROP, PDA, late onset sepsis, severe IVH and oxygen requirement at 36 weeks of corrected gestational age. CONCLUSIONS: RDS had a high incidence in very low birth weight infants, despite the frequent use of antenatal steroids. VLBW Infants with RDS had a higher mortality and an increase risk of relevant morbidity. RDS also increased use of resources.
Subject(s)
Respiratory Distress Syndrome, Newborn , Female , Humans , Incidence , Infant, Newborn , Infant, Very Low Birth Weight , Male , Prospective Studies , Respiratory Distress Syndrome, Newborn/complications , Respiratory Distress Syndrome, Newborn/epidemiology , Respiratory Distress Syndrome, Newborn/therapy , Risk FactorsABSTRACT
Objetivo. Analizar la incidencia, factores de riesgo, morbilidad relevante, empleo de recursos y mortalidad, en recién nacidos (RN) de muy bajo peso de nacimiento (<1500 g) con síndrome dedificultad respiratoria (SDR).Población y métodos. Estudio observacional y analítico. Se incluyeron 5991 RN vivos <1500 g de las 20 unidades de la Red Sudamericana de Neonatología (Neocosur) entre 2002 y 2007. Los datos se ingresaron prospectivamente en fichaselectrónicas en línea en el sitio web.Resultados. La edad gestacional (media) fue de 29,1 semanas (IC 95 por ciento 29,06-29,2) y el peso de nacimiento (medio) de 1100,5 g (IC 95 por ciento 1093,79-1107,3). La incidencia de SDR fue del 74 por ciento (IC 95 por ciento73-75). El principal factor de riesgo para el SDR fue la menor edad gestacional (p< 0,001), mientrasque la administración antenatal de corticoides (OR: 0,59; IC 95 por ciento 0,49-0,72), sexo femenino (OR: 0,77; IC 95 por ciento 0,67-0,89) y rotura prematura de membranas (OR: 0,81; IC 95 por ciento 0,68-0,96)constituyeron factores protectores. En los RN con SDR, el empleo antenatal de corticoides se asoció a menor mortalidad (OR: 0,40; IC 95 por ciento0,34-0,47). El uso de recursos fue mayor en el grupo con SDR, con más empleo de surfactante(74,3 por ciento contra 7,3 por ciento, p< 0,001), de ventilaciónmecánica (82,1 por ciento contra 23,8 por ciento, p< 0,001), más días de oxigenoterapia (p< 0,001) y de hospitalización (p< 0,001).Conclusiones. El SDR tuvo una elevada incidencia en RN< 1500 g y produjo un aumento en la mortalidad, morbilidad y en el empleo de recursos.
Objective. To analyze the incidence, risk factors, major morbidity, mortality and resource employment in very low birth weight infants (< 1500 g) with respiratory distress syndrome (RDS).Methods. Descriptive study using prospectively obtained on-line information from a data base of 20 units belonging to the South American Neocosur Network. A total of 5991 VLBW infants were registered during years 2002-2007. Results. The mean gestacional age was 29.1 weeks (95 percent CI 29.06-29.21) and the mean of birth weight was 1100.5 g (95 percent CI 1093.79-1107.37). The global incidence of RDS was 74 percent (95 percent CI 73-75). Antenatal steroids were administered to 73 percent of this population. The main risk factor was lower gestational age (p< 0.001); where as prenatal steroids (OR: 0.59; 95 percent CI 0.49-0.72), female gender (OR: 0.77; 95 percent CI 0.67-0.89) and premature rupture of membranes (OR: 0.81; 95 percent CI 0.68-0.96) were protective factors. Antenatal steroids was also associated with a decrease in mortality in those infants that presented with RDS (OR: 0.40; 95 percent CI 0.34-0.47). Use of resources was higher in the group with RDS, with a greater use of surfactant (74.3 percent vs. 7.3 percent, p< 0.001), mechanical ventilation (82.1 percent vs. 23.8 percent, p< 0.001), and more days of oxygen (median of 8 vs. 1 day, p< 0.001) and hospitalization (median of 61 vs. 45 days, p< 0.001). RDS was associated to an increase risk in the incidence of ROP, PDA, late onset sepsis, severe IVH and oxygen requirement at 36 weeks of corrected gestational age. Conclusions. RDS had a high incidence in very low birth weight infants, despite the frequent use of antenatal steroids. VLBW Infants withRDS had a higher mortality and an increase risk of relevant morbidity. RDS also increased use of resources.
Subject(s)
Humans , Male , Female , Infant, Newborn , Adrenal Cortex Hormones/therapeutic use , Infant, Very Low Birth Weight , Multicenter Studies as Topic , Risk Factors , South America , Respiratory Distress Syndrome, Newborn/complications , Respiratory Distress Syndrome, Newborn/mortality , Observational Studies as TopicABSTRACT
Objetivo. Analizar la incidencia, factores de riesgo, morbilidad relevante, empleo de recursos y mortalidad, en recién nacidos (RN) de muy bajo peso de nacimiento (<1500 g) con síndrome dedificultad respiratoria (SDR).Población y métodos. Estudio observacional y analítico. Se incluyeron 5991 RN vivos <1500 g de las 20 unidades de la Red Sudamericana de Neonatología (Neocosur) entre 2002 y 2007. Los datos se ingresaron prospectivamente en fichaselectrónicas en línea en el sitio web.Resultados. La edad gestacional (media) fue de 29,1 semanas (IC 95 por ciento 29,06-29,2) y el peso de nacimiento (medio) de 1100,5 g (IC 95 por ciento 1093,79-1107,3). La incidencia de SDR fue del 74 por ciento (IC 95 por ciento73-75). El principal factor de riesgo para el SDR fue la menor edad gestacional (p< 0,001), mientrasque la administración antenatal de corticoides (OR: 0,59; IC 95 por ciento 0,49-0,72), sexo femenino (OR: 0,77; IC 95 por ciento 0,67-0,89) y rotura prematura de membranas (OR: 0,81; IC 95 por ciento 0,68-0,96)constituyeron factores protectores. En los RN con SDR, el empleo antenatal de corticoides se asoció a menor mortalidad (OR: 0,40; IC 95 por ciento0,34-0,47). El uso de recursos fue mayor en el grupo con SDR, con más empleo de surfactante(74,3 por ciento contra 7,3 por ciento, p< 0,001), de ventilaciónmecánica (82,1 por ciento contra 23,8 por ciento, p< 0,001), más días de oxigenoterapia (p< 0,001) y de hospitalización (p< 0,001).Conclusiones. El SDR tuvo una elevada incidencia en RN< 1500 g y produjo un aumento en la mortalidad, morbilidad y en el empleo de recursos.(AU)
Objective. To analyze the incidence, risk factors, major morbidity, mortality and resource employment in very low birth weight infants (< 1500 g) with respiratory distress syndrome (RDS).Methods. Descriptive study using prospectively obtained on-line information from a data base of 20 units belonging to the South American Neocosur Network. A total of 5991 VLBW infants were registered during years 2002-2007. Results. The mean gestacional age was 29.1 weeks (95 percent CI 29.06-29.21) and the mean of birth weight was 1100.5 g (95 percent CI 1093.79-1107.37). The global incidence of RDS was 74 percent (95 percent CI 73-75). Antenatal steroids were administered to 73 percent of this population. The main risk factor was lower gestational age (p< 0.001); where as prenatal steroids (OR: 0.59; 95 percent CI 0.49-0.72), female gender (OR: 0.77; 95 percent CI 0.67-0.89) and premature rupture of membranes (OR: 0.81; 95 percent CI 0.68-0.96) were protective factors. Antenatal steroids was also associated with a decrease in mortality in those infants that presented with RDS (OR: 0.40; 95 percent CI 0.34-0.47). Use of resources was higher in the group with RDS, with a greater use of surfactant (74.3 percent vs. 7.3 percent, p< 0.001), mechanical ventilation (82.1 percent vs. 23.8 percent, p< 0.001), and more days of oxygen (median of 8 vs. 1 day, p< 0.001) and hospitalization (median of 61 vs. 45 days, p< 0.001). RDS was associated to an increase risk in the incidence of ROP, PDA, late onset sepsis, severe IVH and oxygen requirement at 36 weeks of corrected gestational age. Conclusions. RDS had a high incidence in very low birth weight infants, despite the frequent use of antenatal steroids. VLBW Infants withRDS had a higher mortality and an increase risk of relevant morbidity. RDS also increased use of resources.(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant, Very Low Birth Weight , Respiratory Distress Syndrome, Newborn/complications , Respiratory Distress Syndrome, Newborn/mortality , Risk Factors , Multicenter Studies as Topic , South America , Adrenal Cortex Hormones/therapeutic use , Observational Studies as TopicABSTRACT
Amantadine has been used for prevention and treatment of influenza A infection. It blocks the proton through the M2 ion channel. Drug-resistant viruses appear quickly when this therapy is used. Single amino acids changes in the H2 protein can confer resistance, being the most frequent one in position 31. Different methods to detect resistant strains have been described. The objectives were to determine the existence of amantadine resistance of influenza A strains isolated in a virologic laboratory in Santiago, Chile, between 2001-2002, and to validate a new molecular method to detect resistant strains. A PCR restriction fragment length polymorphism analysis was employed for the detection of resistant viruses. In 31 processed strains no mutation in the position 31 was found. This result supports that amantadine resistance is very low or absent in Chile. This could be explained by a limited use of this drug in the study population. This method could be used as a monitoring system to survey resistant viruses.
