Confidential enquiry into deaths due to prematurity.
The aim of this study was to audit the management of neonatal respiratory distress syndrome (RDS) in a geographically defined population using a retrospective peer review of case notes.
The subjects were 49 infants of 24-36 wk gestation with a birthweight>499 g, and dying as a consequence of prematurity at
Forty-four infants (90%) were delivered in a unit with staff experienced in the management of preterm birth.
Of the 30 infants<30 weeks'gestation, 29 (97%) received neonatal intensive care on a (sub) regional unit.
Pre-delivery corticosteroids were indicated in 34 cases and administered in 31 (91%). Resuscitation at birth was indicated in 47 infants and conducted satisfactorily in 42 (89%). Temperature on admission to the neonatal unit was not recorded in 7 infants ; in the other 42 it was>35.5 °C in 21 (50%). Early surfactant therapy was administered to 31/34 (91%) infants still intubated 120min after birth, but was given within 30 min to only 8 (24%). Mechanical ventilation was assessed in 41 infants and considered to be good in 23 (56%). Cardiovascular therapy was evaluated in 40 infants requiring active support and considered to be good in 31 (78%). We concluded that neonatal RDS was generally well managed, thermal care during resuscitation was poor, surfactant should be administered more promptly, and deficiencies in the management of ventilation were common and related mainly to poor anticipation and a slow response to problems.
Mots-clés Pascal : Prématurité, Nouveau né, Homme, Complication, Détresse respiratoire, Royaume Uni, Europe, Epidémiologie, Evaluation, Efficacité, Réanimation, Température corporelle, Surfactant pulmonaire, Ventilation assistée, Nouveau né pathologie, Gestation pathologie, Appareil respiratoire pathologie
Mots-clés Pascal anglais : Prematurity, Newborn, Human, Complication, Respiratory distress, United Kingdom, Europe, Epidemiology, Evaluation, Efficiency, Resuscitation, Body temperature, Pulmonary surfactant, Assisted ventilation, Newborn diseases, Pregnancy disorders, Respiratory disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0192622
Code Inist : 002B11D. Création : 16/11/1999.