OBJECTIVE: To design a portable respiratory device for transporting premature infants and explore its application effect in the in-hospital transportation of extremely premature infants in primary hospitals. METHODS: A prospective randomized controlled trial was conducted. The extremely premature infants born and transferred to neonatal intensive care unit (NICU) with oxygen therapy support from May to October in 2023 were selected and randomly divided into control group and observation group. The infants in the control group received respiratory support and in-hospital transportation using a traditional T-combination resuscitator connected to pure oxygen, and those in the observation group used a portable premature infant transport respiratory device designed and manufactured by medical staff to provide respiratory support and implement in-hospital transportation. The respiratory device for transporting premature infants is made of 304 stainless steel material, mainly consisting of a T-combination resuscitator, an air oxygen mixer, an air tank, a pure oxygen cylinder, a pressure reducing valve, a telescopic rod, a tray, a hook, a bottom plate, and four moving wheels, which can achieve precise control of the fraction of inspired oxygen (FiO₂) during transportation. The achievement rate of first-time target pulse oxygen saturation (SpO₂, achieving a target SpO₂ of 0.90-0.95 was considered as meeting the standard) and arterial partial pressure of oxygen (PaO₂) after being transferred to the NICU, as well as the manpower expenditure and time required for transportation of pediatric patients between the two groups were observed. RESULTS: A total of 73 extremely premature infants were enrolled, including 38 in the control group and 35 in the observation group. There was no significant difference in the gender, gestational age at birth, birth weight, mode of delivery, Apgar score at 1 minute and 5 minutes after birth, and oxygen therapy during the transportation between the two groups. The achievement rate of first-time target SpO₂ after NICU in the observation group was significantly higher than that in the control group [94.29% (33/35) vs. 26.32% (10/38), P < 0.05], the PaO₂ control range was better [mmHg (1 mmHg = 0.133 kPa): 85.50±6.36 vs. 103.00±2.83, P < 0.05], manpower expenditure and time required for transportation were significantly reduced [manpower expenditure (number): 2.14±0.35 vs. 3.17±0.34, time required for transportation (minutes): 10.42±0.76 vs. 15.54±0.34, both P < 0.05]. CONCLUSIONS The portable respiratory device for transporting premature infants is used for respiratory support during the transportation of extremely premature infants in primary hospitals. It can improve the achievement rate of target SpO₂, control PaO₂ within the target range, and avoid hypoxia or hyperoxia during transportation. The breathing apparatus is compact, easy to carry, can save labor resources and time during transport, is cost-effective, and is suitable for widespread application in primary hospitals.
Humans ; Infant, Newborn ; Transportation of Patients ; Prospective Studies ; Equipment Design ; Infant, Extremely Premature ; Intensive Care Units, Neonatal ; Infant, Premature

The high incidence of complications in preterm infants has a serious negative impact on neonatal health.Therefore,the discovery of predictors of complications in preterm infants has a positive clinical value.Umbilical cord blood is rich in various biomarkers and has the advantages of easy access and no harm to the infants,making it an ideal specimen for testing.A number of studies had explored the predictive value of de-tecting markers in umbilical cord blood,either alone or in combination with other assays,for various types of preterm complications,in order to facilitate earlier intervention for preterm complications and to improve the prognosis of the disease.This paper reviews the recent development of cord blood testing for predicting com-plications in various types of preterm infants.

Objective:To investigate the influential factors of neonatal hypoxic ischemic encephalopathy (HIE), and compare the therapeutic effects of mild hypothermia at different time windows and between different degrees of disease severity.Methods:Eighty-two neonates with HIE who were admitted to Jiaxing Maternity and Child Health Care Hospital from January 2016 to October 2021 were included in the patient group, and 123 concurrent healthy neonates were included in the control group. The influential factors of neonatal HIE were analyzed. Sixty-five neonates who received HIE were divided into four groups according to the time length between symptom onset and hospital admission (< 6 hours and 6-12 hours) and disease severity: group I (admission time < 6 hours, mild, n = 20), group II (admission time < 6 hours, moderate to severe, n = 15), group III (admission time 6-12 hours, mild, n = 17), and group IV (admission time 6-12 hours, moderate to severe, n = 13). Amplitude-integrated electroencephalography (aGGE) score was used as the evaluation criteria. The therapeutic effects of mild hypothermia were compared between different time windows and between different degrees of HIE. Results:Multivariable logistic regression analysis results revealed that the influential factors of neonatal HIE included gestational hypertension, gestational diabetes, pregnancy examination, delivery methods, amniotic fluid contamination, abnormal fetal membranes (placenta or umbilical cord), fetal distress, and neonatal asphyxia ( P < 0.05). All 65 neonates with HIE underwent mild hypothermia treatment for 72 hours. Before treatment, aGGE score in groups I, II, III and IV was 6.02 ± 1.74 points, 2.43 ± 1.82 points, 5.23 ± 1.95 points, and 2.72 ± 1.76 points, respectively. After treatment, it was 8.13 ± 2.03 points, 6.47 ± 1.87 points, 7.86 ± 1.92 points, and 3.52 ± 1.95 points, respectively. There was significant difference in aGGE score between before and after treatment in groups I, II and III ( t = 2.87, 3.55, 3.15, all P < 0.05). aGGE score in group IV did not differ significantly between before and after treatment ( P > 0.05). Before treatment, aGGE score in children with moderate to severe HIE was lower than that in children with mild HIE. After treatment, there was no significant difference in aGGE score between groups II and III ( P > 0.05). Conclusion:Pregnant women with gestational hypertension and gestational diabetes should be given intensive monitoring and learn HIE related knowledge to increase the frequency of prenatal examinations. If amniotic fluid contamination, abnormal fetal membranes (placenta or umbilical cord), fetal distress, or neonatal asphyxia occurs, timely monitoring and corresponding interventions should be given to the fetus. Mild hypothermia therapy has a certain therapeutic effect on different degrees of HIE. For moderate to severe neonates, treatment should be started within 6 hours to ensure the therapeutic effects of mild hypothermia.

Objective To study the distribution and drug resistance of pathogens in neonatal septicemia in order to provide clinical guidance for antibiotic usage.Methods This retrospective study analyzed blood culture and clinical data from 83 confirmed neonatal septicemia patients and the blood collection cultures were analyzed.Results A total of 84 strains were isolated from 83 cases of blood specimens,Gram positive bacteria,Gram negative bacteria and fungi were 38(45.2%),41(48.8%),5(6.0%),respectively.Gram positive bacteria was mainly coagulase negative staphylococcus and staphylococcus aureus,which were 13(15.5%) and 8(9.5%) respectively.Gram negative bacteria was mainly Escherichia coli and Klebsiella pneumonia,which were 25(29.8%) and 9(10.7%) respectively.Gram positive bacteria were found high resistance to penicillin G,amoxicillin clavulanate potassium,oxacillin and clindamycin,from 34.2% to 73.7%,but they were sensitive to vancomycin,teicoplanin and linezolid.Gram negative bacteria were found high resistance to ampicillin(82.9%),the constituent ratio of the extended spectrum βlactamases(ESBLs) was 34.1%,carbapenem resistant strains was not found.All fungi were sensitive to azoles.Conclusion Gram negative bacteria are the major pathogens in neonatal septicemia,with high infection rate of Escherichia coli and high constituent ratio of the ESBLs,and antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility results.

OBJECTIVE To study the disposition,hospital divisions and risk factors that induce nosocomial infections,and approach utility measure for prevention.METHODS To investigate and analyze the nosocomial infections in the patients who hospitalized from 2004 to 2006,through the way combined with retrospective investigation and the cases report by doctors.RESULTS In our hospital,the nosocomial lower respiratory tract infection was the highest(33.7%).The second was the upper respiratory tract infection(23.0%),and the gastrointestinal tract infection(18.7%).The incidence of nosocomial infection in medical and paediatrics department was higher than other departments,the main infection site in internal medicine department was lower respiratory tract(49.1%),but in pediatrics it was skin soft tissue infection(41.6%).There was significance difference of risk factors in nosocomial infection.CONCLUSIONS To grasp the causes of nosocomial infection,emphasize the monitoring for the high risk factors in departments,strengthen the prevention for nosocomal infection among the staff,standardize the various kinds of nursing operation and reasonably apply antibiotics,all are the effective measures for the prevention of nosocomial infection.