ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG, CHẨN ĐOÁN VÀ KẾT QUẢ ĐIỀU TRỊ SUY HÔ HẤP Ở TRẺ SƠ SINH NON THÁNG TẠI KHOA HỒI SỨC SƠ SINH BỆNH VIỆN NHI ĐỒNG 1

Abstract

Background: Preterm birth, defined as infants born before 37 weeks of gestation, poses significant challenges in diagnosing and treating respiratory distress, with diagnosis confirmed by arterial blood gas results^[5][7]. Globally and in Vietnam, research on respiratory distress in preterm infants is extensive. However, in recent years, there have been few specific and focused studies on respiratory distress in preterm infants at our center. Therefore, we conducted this study to describe the characteristics of respiratory distress in preterm infants at the Neonatal Intensive Care Unit of Children's Hospital 1. Objectives: To determine the percentage of clinical, diagnostic, and treatment outcome characteristics of respiratory distress in preterm infants at the Neonatal Intensive Care Unit of Children's Hospital 1. Methods: A cross-sectional study from January 1, 2025, to June 30, 2025, at Children's Hospital 1. Results: There were 145 cases of respiratory distress in preterm infants during the study period. The median gestational age was 34,0 weeks (29,4 – 35,0 weeks), the median birth weight was 1900g (1300 – 2300g), and the proportion of extremely preterm infants was 12,4%. The most common clinical symptoms were severe chest wall retraction and cyanosis, both occurring in 46,2%. Other signs included tachypnea (24,8%), grunting (24,1%) and apnea (15,9%). The main paraclinical abnormalities were abnormal chest X-ray (55,2%), metabolic acidosis (24,8%), elevated CRP (17,2%), leukocytosis (16,6%) and thrombocytopenia (16,6%). Common causes of respiratory distress included surgical diseases (36,6%), respiratory distress syndrome (34,5%), pneumonia (24,1%), congenital heart disease (12,4%), transient tachypnea of the newborn (10,3%), and pulmonary hypertension (5,5%). The main treatments provided were antibiotic therapy (100,0%), invasive mechanical ventilation (74,5%), non-invasive mechanical ventilation (73,1%), surfactant replacement therapy (35,2%) and caffeine (35,2%). The primary treatment outcomes were hospital discharge (87,0%), and mortality (13,0%). Complications were accounting for 31,0% of the cases, with bronchopulmonary dysplasia being the most common (9,0%). Conclusion: The most common cause of respiratory distress in preterm infants was surgical diseases (36,6%), respiratory distress syndrome (34,5%), with invasive mechanical ventilation used in 74,5% of cases. The mortality rate was 13,0%. The rate of bronchopulmonary dysplasia was 9,0%. Appropriate diagnostic and treatment strategies are needed to reduce mortality and bronchopulmonary dysplasia rates.