Spectrum of neonatal diseases requiring respiratory support in UBTH, Benin City, Edo State, Nigeria

Abstract

Abstract: Introduction: In Nige- ria, eighty two percent of the three leading causes of neonatal mortal- ity may require respiratory sup- port for their management, yet this is unavailable. Objective: To review the spec- trum of respiratory disorders that were ventilated, their outcomes and the contribution of such sup- port to survival Methods: A data base of cases managed in the unit is maintained and reviewed regularly for en- hancement of quality of care. Such prospectively documented information on babies who re- ceived respiratory support over the period 1stJanuary to 31stJune 2014 were analysed. Results: Five hundred and seventy six babies were admitted. Forty- nine (8, 5%) received ventilator support. These comprised preterm (77.6%) and term (22.4%) babies with mean gestational age of 33.2 weeks (range 28-41). The spec- trum of disorders supported were: respiratory distress syndrome (RDS) 55.1%, asphyxia 20.4%, sepsis12.3%, acute bilirubin en- cephalopathy cephalopathy (ABE) 8.2%, tran- sient tachypnoea of the new-born (TTNB) 2% and neonatal tetanus (NT) 2%. They were non- invasive support (NIVRS) 33(67.3%) for respira- tory distress; invasive support (IVRS) 16(32.7%) for respiratory failure. NIVRS was mostly for RDS (88.9%); ABE (100%) re- ceived invasive support. Mortal- ity was: NIVRS7/33(21.2%); IVRS 11/16(68.75 %). Respiratory dysfunction contributed 25.4% of the total neonatal mortality of 123 per thousand. Survival was 63.3%. Conclusion: The morbidities were: asphyxia, prematurity, sepsis, ABE, and tetanus. Ventilator sup- port was non-invasive with bubble CPAP and invasive with mechani- cal ventilation through endotra- cheal intubation. Survival was improved. There is the urgent need to commence and sustain basic non -invasive respiratory support in all neonatal