Clinical and Paraclinical Characteristics and Results of Treatment of Neonatal Respiratory Failure at the Department of Pediatrics, Khanh Hoa Provincial General Hospital in 2023-2024

Respiratory failure is a common syndrome in the neonatal period, especially in the first days after birth. It is the leading cause of death and has high treatment costs. Respiratory failure in newborns has diverse clinical manifestations and causes, varying depending on age. The study was conducted to describe the clinical and paraclinical characteristics, causes and treatment results of respiratory failure at the Department of Pediatrics, Khanh Hoa Provincial General Hospital in 2023-2024. Subjects and methods: Cross-sectional study of 88 children diagnosed with neonatal respiratory failure and treated as inpatients at the Pediatrics Department of Khanh Hoa Provincial General Hospital in 2023- 2024. Result: The study results showed that the male/female ratio was 1.44/1. The average gestational age was 35.1 ± 4.0 weeks with 39.8% of infants ≥ 37 weeks. The average weight was 2511.6 ± 922.8g, of which 77.3% were normal, 15.9% were malnourished, and 6.8% were overnourished. Normal birth 58.0%, postpartum asphyxia 15.9%, postpartum endotracheal resuscitation 8.0%. Mothers with risk factors 26.2%. Children < 34 weeks with full antenatal steroid prophylaxis 33.3%. Peripheral blood SpO2 < 90% 18.9%.Rapid breathing 77.3%, intercostal retractions 93.2%, altered consciousness 43.5%; body temperature changes 25.0% and heart rate changes 15.9%. Decreased pH, decreased PaO2, increased PaCO2, accounted for 65.5%; 14.5% and 16.4% respectively. Over 85% of the group of children with respiratory failure had hemoglobin, white blood cells and platelets concentrations within normal values. CRP increased > 10 mg/dL was 12.0%. Chest X-ray showed fine granular/reticular/diffuse opacity lesions in 25.0%. Mild respiratory failure in newborns was 24.1%; moderate was 58.0% and severe was 8.0%. Pulmonary causes accounted for 80.7%. Oxygen therapy, including nasal cannula oxygen 34.1%; NCPAP 52.3% and mechanical ventilation 13.6%. The results of treatment of neonatal respiratory failure were 78.4% of children recovered and were discharged from the hospital. There was a relationship between gestational age, birth weight, postnatal nutritional status, 1-minute Apgar score, balloon resuscitation, antenatal steroid prophylaxis, level of respiratory distress syndrome, SpO2 at admission, treatment time and treatment results of neonatal respiratory distress syndrome (p<0.05). Conclusion: This study clarifies the clinical and paraclinical characteristics, causes of neonatal dyspnea, as well as the important role of factors such as gestational age, birth weight and Apgar score in the treatment outcomes of neonatal dyspnea at Khanh Hoa General Hospital. Understanding these factors can improve management and treatment. Therefore, it is necessary to improve the expertise in neonatal intensive care and coordinate models of mother-baby resuscitation.