Clinical Analysis of NICU Oxygen Therapy over 28 Days in a Single Center

Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v2i4.553

Fujian Shi¹, Upendra yadav¹, Xiaofang Zhu²

1. The Second Clinical Medical College of Yangtze University
2. Department of Neonatology, Jingzhou Central Hospital affiliated to Yangtze University

Abstract

Objective — To investigate the main causes, related factors and clinical outcomes of neonates with continuous oxygen therapy ≥ 28 days in neonatal intensive care unit（NICU） of our hospital. Methods — Clinical data of neonates admitted to NICU from January 2015 to December 2020 who needed continuous oxygen therapy ≥ 28 days after birth were retrospectively analyzed. The causes of continuous oxygen therapy ≥ 28 days, general condition with oxygen and respiratory support, duration and clinical outcomes were recorded. Independent samples t test, Mann-Whitney rank sum test, c² test were used for statistical analysis. Results — In the past 6 years, 115 cases met the inclusion criteria and who received continuous oxyogen therapy ≥ 28 days after birth. 1. Gestational age: 25⁺¹~40⁺⁰, <32 weeks of gestation accounted for 83.5%. The peak gestational age occurred at 28⁺⁰~29⁺⁶ weeks after continuous oxygen therapy for ≥ 28 days. 2. Main causes: 37 cases (32.2%) of bronchopulmonary dysplasia (BPD), 36 cases (31.3%) of neonatal pneumonia, 20 cases (17.4%) of apnea of prematurity (AOP), Pulmonary hypertension was reported in 8 cases (7.0%), laryngotrachealacia in 2 cases (1.7%), cyanosis congenital heart disease in 4 cases (3.5%), and other causes in 8 cases (7.0%). 3. Short-term prognosis: of 105 premature infants, 90 were successfully deoxygenated, accounting for 85.7%; In 10 cases, 5 cases (50%) were successfully deoxygenated. 20 cases gave up treatment or died. 4. Long-term oxygen therapy was related to gestational age and duration of ventilator. The younger the gestational age, the longer the mechanical ventilation time and the longer the total oxygen therapy time (P < 0.05). Conclusion — Continuous oxygen therapy ≥ 28 days received in all gestational age group. Preterm infants with gestational age < 32 weeks had the highest incidence. The main causes of premature infants with gestational age < 32 weeks are BPD, neonatal pneumonia, AOP and pulmonary hypertension. Neonatal pneumonia was the main cause in preterm infants with gestational age 32⁺⁰~34⁺⁶ weeks, and congenital dysplasia and genetic metabolic diseases were the main cause in neonates above 35 weeks gestational age group.

Keywords

NICU, continuous oxygen therapy ≥ 28 days, cause, risk factors

Full Text

PDF - Viewed/Downloaded: 16 Times

References

[1] JOBE AH B E. Bronchopulmonary dysplasia[J]. Am J Respir Crit Care Med, 2001, 7(163): 1723-1729.
[2] HIGGINS R D, JOBE A H, KOSO-THOMAS M, et al. Bronchopulmonary Dysplasia: Executive Summary of a Workshop[J]. The Journal of pediatrics, 2018, 197: 300-308.
[3] Shao Xiaomei, Ye Hongmao, QIU Xiaoshan. Practical neonatology [M]. 5th ed. Beijing: People's Medical Publishing House,2019.
[4] HIGGINS R D, BANCALARI E, WILLINGER M, et al. Executive summary of the workshop on oxygen in neonatal therapies: controversies and opportunities for research[J]. Pediatrics (Evanston), 2007, 119(4): 790.
[5] OLIVEIRA L, COELHO J, FERREIRA R, et al. Oxigenoterapia Domiciliária de Lonag Duração na Criança: Evidências e Questões em Aberto[J]. Acta médica portuguesa, 2014, 27(6): 717.
[6] LIGNELLI E, PALUMBO F, MYTI D, et al. Recent advances in our understanding of the mechanisms of lung alveolarization and bronchopulmonary dysplasia[J]. American journal of physiology-Lung cellular and molecular physiology, 2019, 317(6): L832-L887.
[7] POPOVA A P. Mechanisms of bronchopulmonary dysplasia[J]. Journal of cell commun cation and signaling, 2013, 72(2): 119-127.
[8] LUNA PAREDES M C, ASENSIO DE LA CRUZ O, CORTELL AZNAR I, et al. Fundamentos de la oxigenoterapia en situaciones agudas y crónicas: indicaciones, métodos, controles y seguimiento[J]. Anales de pediatría (Barcelona, Spain: 2003), 2009, 71(2): 161-174.
[9] LIU J, CHEN S, LIU F, et al. BPD, Not BPD, or iatrogenic BPD: findings of lung ultrasound examinations[J]. Medicine (Baltimore), 2014, 93(23): e133.
[10] HAYES D J, WILSON K C, KRIVCHENIA K, et al. Home Oxygen Therapy for Neonates. An Official American Thoracic Society Clinical Practice Guideline[J]. Am J Respir Crit Care Med, 2019, 199(3): e5-e23.
[11] Ones KL.Dysmolphology approach and classification[M]//Smith’s Recognizable Patterns of Human Malformation.7th ed. Elsevier Saunders, Philadelphia, 2013: 1.
[12] LO BUE A, SALVAGGIO A, INSALACO G. Obstructive sleep apnea in developmental age. A narrative review[J]. European journal of pediatrics, 2020, 179(3): 357-365.
[13] WANG Chenhong, SHEN Xiaoxia, Chen Mingyan, et al. Diagnosis and prognosis of bronchopulmonary dysplasia in premature infants with different diagnostic criteria [J]. Chin J pediatr, 2020, 58(5): 381-386.
[14] ARSAN S, KORKMAZ A, OGUZ S. Turkish Neonatal Society guideline on prevention and management of bronchopulmonary dysplasia[J]. Türk Pediatri Arşivi, 2019, 53(sup1): 138-150.
[15] KATIRA B H. Ventilator-Induced Lung Injury: Classic and Novel Concepts[J]. Respiratory Care, 2019, 64(6): 629-637.
[16] BALANY J, BHANDARI V. Understanding the Impact of Infection, Inflammation, and and Their Persistence in the Pathogenesis of Bronchopulmonary Dysplasia[J]. Frontiers in Medicine, 2015, 2.
[17] BRENER D P, NINO G Y, GALLETTI M F, et al. Bronchopulmonary dysplasia: incidence and risk factors[J]. Arch Argent Pediatr, 2017, 115(5): 476-482.

Citing this article:

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License