■2017年定义了新生儿急性呼吸窘迫综合征(NARDS),流行病学数据仍然未知。我们的目标是探索病因,围产期NARDS患者的临床特征和结局。
■多中心,prospective,横断面研究于2018年1月1日至2019年6月30日在中国58个三级新生儿重症监护病房进行.包括诊断为NARDS的新生儿。主要结果是病因因素,临床特征和结果。进行二元逻辑回归和多变量cox比例回归以确定支气管肺发育不良(BPD)和/或死亡或单例死亡的独立预测因子。这项研究已在临床试验中注册。政府,NCT03311165。
■在70,013名入院的新生儿中,NARDS的发生率为1.44%(1005)。累计发病率为65.6%,86.7%,94.1%以内,出生后两天和三天。中位胎龄和出生体重分别为36.4周和2700g。三种主要病因包括肺炎(58.1%),窒息(24.3%)和早发性败血症(EOS)(21.3%)。在213名(21.2%)婴儿中观察到BPD和/或死亡,包括104例(10.3%)BPD和126例(12.6%)死亡。温和的数字,中度和重度NARDS为537(53.4%),286(28.4%)和182(18.2%)。与一剂量或更少的表面活性剂相比,两剂量或更多的表面活性剂与死亡率增加相关(比值比[OR]1.93,95%置信区间[CI]1.20-3.10,P=0.006)。EOS和非EOS触发因素之间的比较也存在相似性(OR1.57,95%CI1.06-2.33,P=0.023)。
■NARDS发病率为1.44%,三种主要病因为肺炎,窒息和EOS。累计发病率为65.6%,86.7%,其中94.1%,出生后两天和三天。我们的结果表明,与一个或更少的表面活性剂剂量相比,两个或更多剂量的表面活性剂会增加死亡率。
■中国国家临床研究中心和重庆医科大学儿童医院临床医学研究计划(NCRC-2019-GP-13),重庆市自然科学基金(cstc2020jcyj-msxmX0197)。
UNASSIGNED: Neonatal acute respiratory distress syndrome (NARDS) was defined in 2017 and the epidemiological data remain unknown. Our objective was to explore aetiological factors, clinical characteristics and outcomes in patients with perinatal NARDS.
UNASSIGNED: A multicentre, prospective, cross-sectional study was performed in 58 tertiary neonatal intensive care units in China from Jan 1, 2018 to June 30, 2019. Neonates diagnosed with NARDS were included. Primary outcomes were aetiological factors, clinical characteristics and outcomes. Binary logistic regression and multivariate cox proportional regression were performed to identify independent predictors for bronchopulmonary dysplasia (BPD) and/or death or single death. This study was registered with ClinicalTrials.Gov, NCT03311165.
UNASSIGNED: Among 70,013 admitted neonates, the incidence of NARDS was 1.44% (1005). The cumulative incidences were 65.6%, 86.7%, 94.1% within one, two and three days after birth. The median gestational age and birth weight were 36.4 weeks and 2700 g. Three main aetiological triggers included pneumonia (58.1%), asphyxia (24.3%) and early-onset sepsis (EOS) (21.3%). BPD and/or death was observed in 213 (21.2%) infants, consisting 104 (10.3%) BPD and 126 (12.6%) deaths. The numbers of mild, moderate and severe NARDS were 537 (53.4%), 286 (28.4%) and 182 (18.2%). Two or more doses of surfactant was associated with increased mortality as compared with one or less doses of surfactant (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.20-3.10, P = 0.006). Similarity also appeared in the comparison between EOS and non-EOS triggers (OR 1.57, 95% CI 1.06-2.33, P = 0.023).
UNASSIGNED: NARDS incidence was 1.44% and the three main aetiologies were pneumonia, asphyxia and EOS. The cumulative incidences were 65.6%, 86.7%, and 94.1% within one, two and three days after birth. Our results suggested that two or more doses of surfactant increased mortality compared with one or less doses of surfactant.
UNASSIGNED: The National Clinical Research Center of China and Clinical Medical Study Program of Children\'s Hospital of Chongqing Medical University (NCRC-2019-GP-13) and Natural Science Foundation of Chongqing (cstc2020jcyj-msxmX0197).