ABSTRACT
PURPOSE: To identify risk factors and predictors of severity associated with meconium aspiration syndrome (MAS) in the patients admitted to the neonatal intensive care unit (NICU). MATERIALS AND METHODS: Retrospective study including newborns admitted, between 2005 and 2015, with a diagnosis of MAS. RESULTS: Of the newborns admitted to the NICU, 0.66% were diagnosed with MAS. These had higher prevalence of caesarean delivery (p < .001), nonreassuring or abnormal cardiotocography (CTG) (p < .001), intrapartum maternal fever (p = .002), Apgar scores at the first minute <7 (p < .001) and need of endotracheal intubation at birth (p < .001). Newborns with severe MAS had higher median reactive C protein (86.9 versus 9.65, p = .001) and 73.3% had pulmonary hypertension (p = .027). They required significantly more days of oxygen therapy, mechanical ventilation, nitric oxide, inotropic, and surfactant therapy, as well as longer hospital stay. CONCLUSIONS: Nonreassuring or abnormal CTG and low Apgar score at the first minute were established as risk factors for MAS and need of surfactant therapy as a predictor of severity.
Subject(s)
Apgar Score , Heart Rate, Fetal , Meconium Aspiration Syndrome/epidemiology , Severity of Illness Index , Adult , C-Reactive Protein/analysis , Case-Control Studies , Cesarean Section/statistics & numerical data , Female , Humans , Infant, Newborn , Intensive Care Units, Neonatal/statistics & numerical data , Intubation, Intratracheal/statistics & numerical data , Male , Meconium Aspiration Syndrome/classification , Obstetric Labor Complications/epidemiology , Pregnancy , Retrospective Studies , Risk Factors , Statistics, Nonparametric , Young AdultABSTRACT
OBJECTIVE: To evaluate nosocomial infections preventive bundle, implemented in April 2010 in Centro Hospitalar de São João (CHSJ) Neonatal Intensive Care Unit (NICU) effectiveness. METHODS: Newborns admitted to level-III NICU of CHSJ, between 1 April 2007 and 31 March 2013, with sepsis as discharge diagnosis, were selected and divided into two periods (Period 1 and 2, before and after new preventive bundle introduction). Data from the two periods were compared. RESULTS: Nosocomial sepsis incidence density decreased significantly from 8.6 to 4.8 per 1000 patient days from Period 1 to 2. Nosocomial infections preventive bundle implementation led to a significant decrease in central line-associated bloodstream infections (CLABSI) rates from 14.1 to 10.4 per 1000 catheter days. CONCLUSIONS: Nosocomial infections preventive bundle implemented revealed efficient in decreasing the incidence density of nosocomial sepsis. However, CLABSI rates remain high. Physicians should be alert to the need to adhere to strict infection control protocols and institute effective measures for nosocomial infection surveillance.
