Spectrum of AKI and its outcome in an out born neonatal intensive care unitA prospective observational study (original) (raw)
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Incidence and Risk Factors of Early Onset Neonatal AKI
Clinical Journal of the American Society of Nephrology, 2019
Background and objectivesNeonatal AKI is associated with poor short- and long-term outcomes. The objective of this study was to describe the risk factors and outcomes of neonatal AKI in the first postnatal week.Design, setting, participants, & measurementsThe international retrospective observational cohort study, Assessment of Worldwide AKI Epidemiology in Neonates (AWAKEN), included neonates admitted to a neonatal intensive care unit who received at least 48 hours of intravenous fluids. Early AKI was defined by an increase in serum creatinine >0.3 mg/dl or urine output <1 ml/kg per hour on postnatal days 2–7, the neonatal modification of Kidney Disease: Improving Global Outcomes criteria. We assessed risk factors for AKI and associations of AKI with death and duration of hospitalization.ResultsTwenty-one percent (449 of 2110) experienced early AKI. Early AKI was associated with higher risk of death (adjusted odds ratio, 2.8; 95% confidence interval, 1.7 to 4.7) and longer du...
Context: World over, four million newborn babies die in the first month of life out of which India contributes to about 1.2 million deaths every year. India thus accounts for a quarter of global neonatal deaths and thus faces the biggest newborn health challenge of any country in the world. Aims: The study was under taken with the objective to determine the morbidity and mortality pattern of among the neonates admitted to a NICU. Settings and design: The study was conducted at Neonatal Intensive Care Unit of Sher-i-Kashmir Institute of Medical Sciences Srinagar (Jammu & Kashmir). This NICU is a level-III NICU center is a tertiary health care institute, where most of the babies referred are high-risk babies. Methods and material: For the objective a descriptive case series, hospital based prospective study was conducted at NICU of SKIMS Srinagar w.e.f. 1 st Jan-31 st Dec 2013 by following neonates from admission to discharge, LAMA or death collecting the data by using a predesigned standardized proforma. Statistical analysis used: The data collected was analyzed by SPSS version 20 and the frequency and percentages of various parameters of morbidity and mortality were calculated. Results: 1017 neonates were admitted in the NICU during the year 2013. Neonatal Jaundice (NNJ) (26.7%) was the most common cause of admission to NICU followed by Septicemia (19.1%) and Prematurity (12.5%) whereas Prematurity (24.2%) was the most common cause of death followed by Septicemia (18.2%), Birth Asphyxia (11.1%) and Meconium Aspiration Syndrome (10.1%). Conclusions: The Neonatal Jaundice (NNJ) was the commonest causes of admission and Prematurity was the most common cause of death and Meconium Aspiration Syndrome was the most common cause of case fatality in NICU in a Tertiary Care Teaching Hospital in Jammu and Kashmir.
Journal of Nepal Paediatric Society, 2013
Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were...
IOSR Journals , 2019
Introduction: Child health in a population has traditionally been assessed by monitoring two key rates-Infant mortality rate and neonatal mortality rate.There is lack of data in respect to morbidity and mortality pattern in NICU of the state of Assam. Hence, this study was undertaken to know the morbidity and mortality profile of newborns admitted in NICU of a tertiary care hospital. Methods: This retrospective study was conducted in neonatal intensive care unit, Tezpur Medical College Hospital over a period of two years. All newborns who were admitted in neonatal intensive care unit during study period were included in the study. Newborns admitted in pediatrics ward were excluded. Data of the newborns were collected from medical record file and monthly reporting format. Result: In this study,out of 2042 newborns admitted in NICU, 65.8% were inborn babies and 34.2% were out born babies. Low birth weight babies were more (51.9%) than normal birth weight babies. The common morbidities were neonatal jaundice (30.06%), birth asphyxia (26.2%) and sepsis (10.8%) respectively. Birth asphyxia cases were seen more in outborn unit (30.5%) .The mortality rate were 9.07% in inborn unit and 11.9% in outborn unit. The overall mortality rate was10.03%. The commonest cause of mortality was birth asphyxia (43.9%) followed by RDS (19.02%) and sepsis (14.6%) respectively. Out of total deaths , 57.6% babies were low birth weight. Conclusion: Birth asphyxia, low birth weight and sepsis are the leading causes of neonatal mortality. This neonatal mortality can be brought down by providing adequate antenatal care, improving maternal nutritional status, close monitoring of fetal wellbeing in pregnancy, timely intervention of delivery , good neonatal resuscitation care and early referral of sick newborns to neonatal intensive care unit.
Asian Journal of Medical Sciences, 2023
Pre-maturity is one of the major health problems and associated with high morbidities and mortality. According to the WHO every year, an estimated 15 million babies are born pre-term and this number is rising. Aims and Objectives: The objectives of the study were to know the various morbidity pattern developed during the clinical course and to identify the cause of mortality of pre-term babies admitted in neonatal intensive care unit (NICU). Materials and Methods: This prospective, observational study was conducted in the Neonatal Intensive Care Unit of Gauhati Medical College and Hospital, Assam, over a period of 1 year. A sample size of 150 pre-term babies selected randomly as per inclusion and exclusion criteria. Results: The total number of cases studied in the present study were 150 pre-term babies admitted in NICU. Male pre-term babies were 82 (54.6%) and female pre-term babies were 68 (45.3%). The various morbidities observed among the pre-term babies during the study period were neonatal hyperbilirubinemia (48%) followed by respiratory distress syndrome (RDS) (30%), neonatal sepsis (22%), hypocalcemia (16%), hypothermia (14.7%), necrotizing enterocolitis (NEC) (5.3%), and intraventricular hemorrhage (4.7%). The overall mortality among the studied cases was 12.6%. Out of 150 cases, 19 cases were expired (12.6%). The present study shows that RDS (36.8%), neonatal sepsis (26.3%), birth asphyxia (21.1%), and NEC (15.7%) were the major causes of mortality among pre-term babies. Conclusion: The survival rate increases significantly with increase in birth weight and gestational age. RDS, birth asphyxia, and neonatal sepsis were the leading causes of death.
International Journal of Advanced Community Medicine, 2020
Background: India faces a daunting challenge of newborn survival. Four out of five newborn deaths result from three treatable conditions: complications during childbirth (including birth asphyxia), newborn infections, and complications from prematurity. The facility-based research is lagging behind. This study was conducted to assess the morbidity profile of the admitted neonates & their outcome in government & private neonatal intensive care units of urban Allahabad. Methods: The present study was conducted in the Neonatal Intensive Care Units of Government and Private settings of urban Allahabad, Uttar Pradesh during the year 2015-2016. This was a time-bound study. All the sick neonates admitted during the study period at SNCH and private NICU of urban Allahabad were included in the study. There were 1,442 neonates who were admitted in both the government and the private newborn care units during the study period. Out of these, only 1,409 neonates were included in the study. Results: In the Government sector, Neonatal sepsis accounted for the maximum number of admission, 26.69% followed by Prematurity 22.17%, Birth Asphyxia 13.54%, Neonatal Jaundice 13.01%, RDS 12.48% and MAS 4.51%. In contrast to this, Prematurity 135 (20.57%) caused maximum number of admissions in the Private sector. The outcome was the best for RDS in government while neonatal jaundice in private sector. Conclusion: The maximum admission in the Neonatal Intensive Care Units of urban Allahabad was caused because of Prematurity followed by Neonatal Sepsis.
IAR Consortium, 2021
Background: SNCUs have reduced the mortality& morbidity along with increased the survival of sick newborns. But the limited knowledge on the magnitude of neonatal morbidity patterns and its associated factors is hampering the early intervention in these SNCUs. This study was undertaken to study the disease pattern and its associated factors among neonates admitted to the inborn sick neonatal intensive care unit of Kamla Nehru Hospital Shimla district of Himachal Pradesh, India. Methods: Retrospective review of five years medical records of all neonates admitted to the Inborn Specialized Neonatal Care Unit of Kamla Nehru Hospital, Shimla covering the period January 2016 to December 2020 was conducted. The most important causes of admissions and its related factors were analyzed. Results: A total of 6607 neonates were admitted in the Inborn SNCU of Kamla Nehru Hospital Shimla in 5 years from Jan 2016 to Dec 2020. Among the total admissions, 3655(55.32%) were males while 2952 (44.68%) were females. Among the total admission in the SNCU in the study period, 3208 (48.55%) neonates were >2500 gm, 2483(37.58%) were1500-2499 gm, 752(11.38%) were 1000-1499gm and 164(2.48%) were <1000gm. Among the total admission 2877(43.54%) were >37 weeks of age, 2392 (36.20%) were 34-37 weeks, 1338(20.25%) were <34 weeks age. Among the total admission at SNCU,maximum 2840 (42.98%) were neonates having Jaundice which required phototherapy followed by Respiratory Distress syndrome 1420(21.49%), moderate &severe Birth Asphyxia 530 (8.02%), Others 463(7.01%), Sepsis 390(5.90%), Other causes of respiratory distress335(5.07%), Major congenital malformation 242(3.66%), Hypoglycemia 242(3.66%), Meconium aspiration syndrome 49(0.74%), Pneumonia 34(0.51%), Meningitis 26(0.39%), Hypothermia 20(0.30%) and HIE 16(0.24%). Conclusion :More centers with neonatal intensive care facilities in the hilly statesshould beestablished up by the government keeping in mind the difficult geographic terrain in Himachal Pradesh.
Pediatric Review: International Journal of Pediatric Research, 2017
Background: Neonatal mortality rate contributes significantly tounder five mortality rates. Data obtained from pattern of admission and outcome may uncover various aspects and may contribute andhelp in managing resources, infrastructure, skilled hands for better outcome in future. Method: This was a retrospective study done in NICU at MM Institute of Medical Sciences. and Research, Ambala, India. Data of all admitted neonates were analyzed with regard toageof babies, sex, weight, cause of admissions and their outcome. Results: During study period a total of 175 neonates were analyzed. Male were predominant over female with maleto female ratio 1.21:1. Majority of newborns were to belonged to low birth weight (46.28%) followed bynormal birth weight (30.28%), very low birth weight (18.28%) and ELBW babies. Maximum number of babies were premature (54%) followed by neonatal sepsis (12.57%), meconium aspiration syndrome (9.17%) and birth asphyxia (9.14%). Out of 175 babies 29 (17.14%) were died. Highest mortality were found with prematurity (62%) followed bybirth asphyxia (20.69%) and neonatal sepsis (10.34%). Conclusion: Prematurity, neonatal sepsis, birth asphyxia and meconium aspiration syndrome were the major indications of admissions. Prematurity, birth asphyxia and neonatal sepsis were major causes of mortality in my study. These mortalities can be reduced with improved management of antenatal and perinatal period, early recognition of conditions, timely intervention and early referral to higher centre.
International Journal of Medical Science and Public Health, 2017
28 days of life. About 40% of all deaths to children under five years of age and nearly two-thirds of infant deaths occur during the neonatal period. [1] Three-quarters of neonatal deaths happen in the 1 st week the highest risk of death is on the 1 st day of life. Globally, the main direct causes of neonatal death are estimated to be preterm birth (28%), severe infections (26%), and asphyxia (23%). [2] During the early neonatal period (0-7 days), the major causes of death are asphyxia, infection, complications of prematurity, and birth defects; infections cause most late neonatal deaths (8-28 days). [1] India is still among the high infant mortality Background: India is still among the high infant mortality rate countries and two third of the infant deaths occur during neonatal period. Neonatal mortality rates have reduced much less than postneonatal death. Morbidity and mortality during neonatal period are mostly due to endogenous factors and survival of the baby depends on timely referral, mode of transportation and treatment available to them. Objectives: Objectives of this study were to describe morbidity pattern among admitted neonates, to find out the association between various biological factors and neonatal morbidity and to study various factors related to referral among outborn neonates. Materials and Methods: The study was a hospital based crosssectional study conducted at neonatal intensive care unit of Guru Gobind Singh Government Hospital, Jamnagar among 300 admitted neonates. Results: In the study 30.00% neonates were outborn, 88.00% were <7 days of age, and 63.67% were male. 32.33% were preterm babies, 59.67% had low birth weight, and 17% were of the birth order 3 or more. Antenatal and intranatal complications were reported by 36.33% and 23.33% mothers, respectively. Chief morbidities were neonatal jaundice (29.33%), respiratory distress syndrome (RDS) (16.33%), perinatal asphyxia (12.00%), infection/sepsis (10.00%), meconium aspiration syndrome (5.33%), and congenital anomalies (8.67%). Infection/sepsis was developed by 19.61% neonates of the birth order 3 or more and 17.14% neonates with intranatal complications. RDS was developed by 24.74% preterm babies and 25.71% with intranatal complications. Out of total outborn neonates, 36.67% were transferred to NICU after 2 days, 67.78% were referred from private institutions, 52.22% used ambulance or 108 services, and 46.67% had to travel for more than 100 km. Conclusion: Birth order 3 or more and any intranatal complication was significantly associated with infection/sepsis. Preterm neonates and intranatal complications showed the significantly higher proportion of RDS. Two third of the outborn neonates were referred by private institutes, and half of the outborn neonates had to travel more than 100 km to reach to NICU.