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

Abstract

Introduction: In Nigeria, eighty two percent of the three leading causes of neonatal mortality may require respiratory support for their management, yet this is unavailable.

Objective: To review the spectrum of respiratory disorders that were ventilated, their outcomes and the contribution of such support to survival

Methods: A data base of cases managed in the unit is maintained and reviewed regularly for enhancement of quality of care. Such prospectively documented information on babies who received respiratory support over the period 1^st January to 31^st June 2014 were analysed.

Results: Five hundred and seventy six babies were admitted. Fortynine (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 spectrum of disorders supported were: respiratory distress syndrome (RDS) 55.1%, asphyxia 20.4%, sepsis12.3%, acute bilirubin encephalopathy (ABE) 8.2%, transient tachypnoea of the new-born (TTNB) 2% and neonatal tetanus (NT) 2%. They were non- invasive support (NIVRS) 33(67.3%) for respiratory distress; invasive support (IVRS) 16(32.7%) for respiratory failure. NIVRS was mostly for RDS (88.9%); ABE (100%) received invasive support. Mortality 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 support was non-invasive with bubble CPAP and invasive with mechanical ventilation through endotracheal intubation. Survival was improved. There is the urgent need to commence and sustain basic non -invasive respiratory support in all neonatal units in Nigeria.

Keywords: Spectrum; Neonatal diseases; Respiratory support