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Surfactant reduced the mortality of neonates with birth weight 1500 g and hypoxemic respiratory failure: a survey from an emerging NICU network

Abstract

Objective:

We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) 1500 g and hypoxemic respiratory failure (HRF).

Study Design:

We retrospectively analyzed 5650 patients with BW 1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure 24 h. The patients were allocated into groups of moderate preterm (1735, 30.7%), late preterm (1431, 25.4%), early term (ETM, 986, 17.5%), full term (1390, 24.6%) and post term (79, 1.4%), with gestational age 33, 34 to 36, 37 to 38, 39 to 41 and 42 weeks, respectively.

Results:

In the five groups, 66.9, 42, 21.6, 12.8 and 5.1% had respiratory distress syndrome (RDS). For pneumonia/sepsis and meconium aspiration syndrome (MAS), the proportion was 13.8%, 25.4%, 38.0%, 52.5% and 76.0%, respectively. Surfactant was given to 21.9% (n=1238) of HRF and 51.2% (n=1108) of RDS. Survival rates of RDS were 82.2%, 87.8%, 84.5%, 77.1% and 75.0%, respectively (numbers needed to treat was 8 to 11 for surfactant benefit). Overall mortality rate of HRF was 21%, or 17.9%, 14.7%, 25.6%, 28.9% and 39.2%, respectively. Mortalities of MAS and pneumonia/sepsis were 29.4 and 27.6%. Relative risk of death was associated with initial disease severity, female gender, mechanical ventilation and congenital anomalies by multivariate logistic regression analysis.

Conclusion:

Surfactant was effective for infants with RDS and BW 1500 g, and different incidences and outcome of HRF among GA groups reflected standard of perinatal and respiratory care in emerging neonatal intensive care unit network.

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Acknowledgements

This study was supported by grants for Excellence in Neonatal Medicine, National Commission of Health and Family Planning, the Project 211 (phase III), Ministry of Education, and Shanghai Municipal Department of Health (No. LJ06038).

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Correspondence to B Sun.

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Additional information

Chinese Collaborative Study Group for Neonatal Respiratory Diseases

Bo Sun6, Huanhuan Wang6, Chao Chen6, Yun Cao6, Liling Qian6, Xirong Gao7, Jinsong Mu7, Yong Xiao7, Jun Li7, Cuiqing Liu8, Yanmei Guo8, 9Chaoying Yang9, Min Qian9, Xinzhu Lin10, Jing Huang10, Changyi Yang11, Bin Yang11, Wenjian Chen11, Zhenlang Lin12, Baiwei Wu12, Wenjun Zhu13, Ning Tan13, Lixia Li13, Zhanghua Hou13, Yue’e Xie13, Xiaoqin Gong13, Zhouli Wu13, Zhenying Yang14, Ji Qi14, Fengqin Yu15, Yingge Kang15, Kai Jang15, Xiaojuan Shi15, Yan Sun15, Wansong Feng15, Yulian Hu15, Yinping Qiu16, Lin Shi16, Fang Zhao16, Baolan Yan16, Yanbo Zhang16, Xianzhi Liu17, Guang Lin17, Qiufen Wei17, Xiaoyu Zhou18, Rui Cheng18, Yun Feng18, Yue Wu18, Yunsu Zou18, Yan Guo18, Qing Que18, Li Zhao18, Li Qian18, Junying Xie19, Hong Xiong20, Huqing Sun20, Shaoru He21, Jin Zhong21, Yifei Wang21, Deyi Zhuang22, Xiaojuan Liu22, Acheng Chen22, Zhengkun He22, Fuqiang Sun23, Yuyan Wang23, Yuqin Chu23, Jie Yang24, Jianwen Xiang24, Hongni Yue25, Liangrong Han25, Dongmei Chen26, Ying He26, Sannan Wang27, Zuming Yang27, Jing Zhou27, Xiaofeng Gu28, Ying Huang28, Ruobing Shan29, Lihua Sun29, Jun Zheng30, Xiaopeng Wang30, Ling Liu31, Wei Wang31, Zhihui Xiao32, Xiaochun Ding32, Xiaoqian Chen32, Mei Li33, Fei Lu33, Xiaoyan Song33, Fang Liu34, Zhimei Guo34, Zhifang Du34, Dezhi Mu35, Ying Xiong35, Hua Wang35, Chao Chen35, Zhijun Wu36, Shanqiu Xiao36, Xiangming Zhou37, Huafei Huang37, Pingming Gao38, Lixia Zhang38, Xiaozhuang Gan39, Lifeng Hou39, Mingyue Liu39, Yuan Shi40, Li Wang40, Bin Yi41, Hongxia Gao41, Xiaohong Liu42, Di Gao42, Lifeng Qi42, Xiaodong Li43, Qing Tian43, Shuping Han44, Danqing Wu44, Zheng Liu45, Yangjiang Chen45, Qin Zhang46, Hongru Lu46, Hua Kang46, Hongtao Lei46, Xiaomei Yang46, Daxin Cheng46, Yuxing Zheng46, Min Yu47, Xiaolei Wang47, Xiaoliang Wang48, Qing Chu48, Wenjuan Tu49, Lin Li49, Baohai Shi50, Guo Yao50, Yan Wang50, Kun Liang51, Qinghua Zhong51, Shaojie Yue52, Zheng’e Liao52, Yuchun Huang53, Yudan Li53, Jichang Chen54, Liming Ni55, Li Zhang55, Juan Zhang55, Jun’an Zeng55, Yanna Fu56, Yuwei Zhao57, Ping Zha57, Yejun Jiang57, Xiaoling Bai58, Yanhua Cao58, Jiahua Pan59, Yong Lv59, Lihong Li60, Jin Bao60

6Children’s Hospital of Fudan University, Shanghai, China; 7Hunan Provincial Children’s Hospital, Changsha, China; 8Hebei Provincial Children’s Hospital, Shijiazhuang, China; 9First Hospital of Jilin University, Changchun, China; 10Xiamen Maternity Hospital, Xiamen, China; 11Fujian Provincial Maternity Hospital, Fuzhou, China; 12Yuying Children’s Hospital of Wenzhou Medical College, Wenzhou, China; 13Chenzhou Children’s Hospital, Chenzhou, China; 14Tai’an Maternity Hospital, Tai’an, China; 15Zhenzhou Maternity Hospital, Zhenzhou, China; 16Ningxia Medical University Hospital, Yinchuan, China; 17Guangxi Maternity Hospital, Nanning, China; 18Nanjing Children’s Hospital of Nanjing Medical University, Nanjing, China; 19Kaifeng Children’s Hospital, Kaifeng, China; 20Zhengzhou Children’s Hospital, Zhengzhou, China; 21Guangdong General Hospital, Guangzhou, China; 22First Hospital of Xiamen University, Xiamen, China; 23Second Hospital of Tianjin Medical University, Tianjin, China; 24Guangdong Provincial Maternity Hospital, Guangzhou, Guangdong, China; 25Huai’an Maternity Hospital, Huai’an, Jiangsu, China; 26Quanzhou Children’s Hospital, Quanzhou, Fujian, China; 27Suzhou Women and Children’s Health Center, Suzhou, China; 28Central Hospital of China National Petroleum Corporation, Langfang, China; 29Qingdao Children’s Hospital, Qingdao, China; 30Tianjin Central Maternity Hospital, China; 31Guiyang Maternity Hospital, Guiyang, China; 32Children’s Hospital of Suzhou University, Suzhou, China; 33Harbin Children’s Hospital, Harbin, China; 34Bethune International Peace Hospital, Shijiazhuang, China; 35Second Hospital of Sichuan University, Chengdu, China; 36Shenzhen Bao’an Maternity Hospital, Shenzhen, China; 37Jiaxing Maternity Hospital, Jiaxing, China; 38Foshan Maternity Hospital, Foshan, China; 39Children’s Hospital of Capital Institute of Pediatrics, Beijing, China; 40Daping Hospital of Third Military Medical University, Chongqing, China; 41Gansu Provincial Maternity Hospital, Lanzhou, China; 42Shenzhen Children’s Hospital, Shenzhen, China; 43Shenzhen Nanshan Hospital, Shenzhen, China; 44Nanjing Maternity Hospital, Nanjing, China; 45Shanxi Provincial Children’s Hospital, Taiyuan, China; 46Shaanxi Provincial General Hospital, Xi’an, China; 47Wuxi General Hospital, Wuxi, China; 48Yuhuangding Hospital, Yantai, China; 49Changzhou Children’s Hospital, Changzhou, China; 50Tai’an Central Hospital, Tai’an, China; 51First Hospital of Kunming Medical College, Kunming, China; 52Xiangya Hospital of Zhongnan University, Changsha, China; 53Dalian Children’s Hospital, Dalian, China; 54Liuzhou Maternity Hospital, Liuzhou, China; 55Shaanxi Provincial Maternity Hospital, Xi’An, China; 56Anhui Provincial Children’s Hospital, Hefei, China; 57Shaoxing Maternity Hospital, Shaoxing, China; 58PLA Military General Hospital, Jinan, China; 59Anhui Provincial Hospital, Hefei, China; 60Changchun Children’s Hospital, Changchun, China.

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Wang, H., Gao, X., Liu, C. et al. Surfactant reduced the mortality of neonates with birth weight 1500 g and hypoxemic respiratory failure: a survey from an emerging NICU network. J Perinatol 37, 645–651 (2017). https://doi.org/10.1038/jp.2016.272

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