Advances in perinatal and neonatal care are closely linked with the improvement in the survival rate of extremely low birth weight infants (ELBWI). Increased survival rate is the result of major changes in obstetrics and neonatal strategies and therapeutic procedures. The question is whether these changes in perinatal care have also brought about shortterm and long-term positive results in morbidity in the child population. Despite the decrease in the neonatal morbidity rate, it appears that neonatal mortality remains stable. Frequently asked questions by parents aimed at medical professionals who are involved in the care of their child include questions on the incidence of adverse neurodevelopmental outcomes. In literature, there is a wide range of different data that interpret the incidence of disorders. We present a review of death rates and short and long-term morbidity in extremely premature infants.
Advances in perinatal and neonatal care are closely linked with the improvement in the survival rate of extremely low birth weight infants (ELBWI). Increased survival rate is the result of major changes in obstetrics and neonatal strategies and therapeutic procedures. The question is whether these changes in perinatal care have also brought about shortterm and long-term positive results in morbidity in the child population. Despite the decrease in the neonatal morbidity rate, it appears that neonatal mortality remains stable. Frequently asked questions by parents aimed at medical professionals who are involved in the care of their child include questions on the incidence of adverse neurodevelopmental outcomes. In literature, there is a wide range of different data that interpret the incidence of disorders. We present a review of death rates and short and long-term morbidity in extremely premature infants.
- MeSH
- gestační stáří MeSH
- kojenec MeSH
- kojenecká mortalita MeSH
- lidé MeSH
- morbidita MeSH
- novorozenci extrémně nezralí růst a vývoj MeSH
- novorozenec MeSH
- perinatální mortalita MeSH
- prognóza MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
V práci sú analyzované niektoré ukazovatele neonatologických úsekov v pôrodniciach Slovenskej republiky v roku 2011 – počet, vek a kvalifikácia lekárov, počet lekárov v pohotovostnej službe, počet novorodeneckých sestier, ako aj aktuálne problémy slovenskej neonatológie v jednotlivých regiónoch.
Some of the indicators of neonatological divisions of delivery hospitals in the Slovak republic in year 2011 are analysed; numbers, age and qualification of doctors, numbers of doctors on duty, numbers of neonatological nurses and recent regional problems of Slovak neonatology.
Cieľ: Vyhodnotenie incidencie bronchopulmonálnej dysplázie (BPD) a ďalších komorbidít na základe iniciálneho ventilačného manažmentu v pôrodnej sále. Metodika: Retrospektívna analýza údajov o novorodencoch narodených na Novorodeneckej klinike FNsP Nové Zámky, v 24.–27. týždni tehotenstva, od narodenia až do prepustenia, v sledovanom období od 1. 1. 2005 do 31. 12. 2009. Súbor pacientov tvorili novorodenci, ktorí boli v pôrodnej sále po aplikácii surfaktantu iniciálne napojení na N-CPAP (nasálny kontinuálny pozitívny tlak v dýchacích cestách) a novorodenci, u ktorých po aplikácii surfaktantu pokračovala umelá pľúcna ventilácia. Okrem incidencie jednotlivých foriem BPD (klasifikácia podľa NICHD – National Institute of Child Health and Human Development) bola v oboch skupinách sledovaná aj komorbidita, dĺžka hospitalizácie, podávanie postnatálnych steroidov. Výsledky: Výsledky našej retrospektívnej analýzy preukázali významne nižšiu incidenciu miernej formy BPD v skupine novorodencov s gestáciou 24 + 0 až 27 + 6 týždňov, iniciálne stabilizovaných včasnou aplikáciou surfaktantu a N-CPAP v porovnaní s novorodencami stabilizovanými včasnou aplikáciou surfaktantu s následnou umelou pľúcnou ventiláciou (25 % vs 70 %, p = 0,001). Incidencia strednej formy BPD bola nižšia v skupine N-CPAP v porovnaní s UPV (umelá pľúcna ventilácia) (5 % vs 12,5 %, p = 0,361). Záver: Okamžité napojenie na N-CPAP bezprostredne po aplikácii surfaktantu u novorodencov s gestáciou 24 + 0 až 27 + 6 týždňov preukázalo benefit v nižšej incidencii BPD, nižšej incidencii komorbidít ako i v skrátení dĺžky hospitalizácie.
Objective: Evaluation of the incidence of bronchopulmonary dysplasia (BPD) and other comorbidities on the basis of initial ventilation management in the delivery room. Methods: Retrospective analysis of data from newborns born at Clinic of Neonatology University Hospital Nove Zamky, at 24th–27th weeks of gestation, from birth until discharge, during the period from 01. 01. 2005 to 31. 12. 2009. Patients were infants who were in the delivery room initially intubated and prophylactic surfactant was administered followed by N-CPAP (nasal continuous positive pressure in pulmonary passages) and babies who after surfactant administration continued on mechanical ventilation. In addition, the incidence of various types of BPD (classification according to NICHD, National Institute of Child Health and Human Development), comorbidities, length of hospitalization, and administration of postnatal steroids were observed in both groups. Results: The results of our retrospective analysis showed significantly lower incidence of mild forms of BPD in the group of newborns with gestation 24+0 to 27+6 weeks initially stabilized by early administration of surfactant and N-CPAP compared with newborn stabilized by early surfactant administration followed by mechanical ventilation (25% vs. 70%; p=0.001). The incidence of secondary forms of BPD was lower in group N-CPAP compared with MV (5% vs. 12.5%, p=0.361). Conclusion: Immediate extubation after surfactant administration to N-CPAP in neonates with gestation 24+0 to 27+6 weeks has shown decrease in the incidence of BPD, and other comorbidities as well as in shortening the length of hospitalization.
Cieľom predkladanej práce bolo vyhodnotiť mortalitu novorodencov v Slovenskej republike, porovnať jej medziročné rozdiely a celkový trend, odhaliť rezervy a stanoviť priority perinatálno-neonatálnej starostlivosti.
The aim of this study was to evaluate the neonatal mortality rate in Slovakia, to compare its interannual differences and the overall trend, to uncover reserves and determine priorities of perinatal–neonatal care.
