Mortality of neonatal respiratory failure from Chinese northwest NICU network

<p><i>Objectives</i>: We aimed to evaluate the efficacy of respiratory support and surfactant in incidence, management and outcome of neonatal hypoxemic respiratory failure (NRF) in Chinese emerging regional neonatal–perinatal care system in the era of universal health insurance policy.</p> <p><i>Study design</i>: Clinical data of NRF were prospectively collected in 12 consecutive months from 2011 to 2012 in 12 neonatal intensive care units (NICU) in major cities of Northwest China. NRF was defined as hypoxemia requiring nasal continuous positive airway pressure (nCPAP) or intratracheal ventilation combined with surfactant for at least 24 h, with associated risk factors, mortality rate and major co-morbidities analyzed.</p> <p><i>Results</i>: Among 9816 admissions, there were 1324 NRF cases with 60.2% being preterm. The incidence of NRF was 13.4% with a mortality of 15.5%. The major underlying diseases were respiratory distress syndrome (RDS, 38.9%) and pneumonia/sepsis (38.0%). Only 15.9% of NRF and 33.8% of RDS received surfactant, which contributed to >70% and >85% survival in RDS patients of birth weight (BW) < 1500 g and >1500 g, respectively. Multivariate logistic regression analysis showed that premature rupture of membrane ≥ 24 h, very low BW and gestational age < 32 weeks, resuscitation at delivery, illness severity at admission, intratracheal ventilation and sepsis were the independent risk factors for the mortality of NRF. The length and cost of NICU stay for survivors reflected care burden in the era of universal health insurance.</p> <p><i>Conclusions</i>: Surfactant significantly improved the survival of neonates with NRF and RDS, reflecting the respiratory care standard in emerging regional neonatal–perinatal care network with limited resources.</p

Appendix H. Diagnostic plots for the regression of first flower date to soil temperature in Carex scabrirostris.

Diagnostic plots for the regression of first flower date to soil temperature in Carex scabrirostris

Appendix A. Change rate of soil temperature at 5 cm per day before 10 August since soil temperature at 5 cm was more than 0°C continuously for 5 days under different years and different elevation gradients.

Change rate of soil temperature at 5 cm per day before 10 August since soil temperature at 5 cm was more than 0°C continuously for 5 days under different years and different elevation gradients

Appendix I. Diagnostic plots for the regression of first flower date to soil temperature in Potentilla anserine.

Diagnostic plots for the regression of first flower date to soil temperature in Potentilla anserine

Appendix B. Diagram of the landscape and experimental sites, transfer process, and monitoring.

Diagram of the landscape and experimental sites, transfer process, and monitoring

Appendix E. Relationships of the differences of first flowering date between transferred and original sites and annual mean air temperature differences for different plant species.

Relationships of the differences of first flowering date between transferred and original sites and annual mean air temperature differences for different plant species

Appendix K. Diagnostic plots for the regression of first flower date to soil temperature in Poa pratensis.

Diagnostic plots for the regression of first flower date to soil temperature in Poa pratensis

Appendix G. Diagnostic plots for the regression of first flower date to soil temperature in Kobresia humilis.

Diagnostic plots for the regression of first flower date to soil temperature in Kobresia humilis

Appendix L. Diagnostic plots for the regression of first flower date to soil temperature in Stipa aliena.

Diagnostic plots for the regression of first flower date to soil temperature in Stipa aliena

Appendix F. Relationships of the differences of first flowering date and annual soil temperature differences between transferred and original sites for different plant species.

Relationships of the differences of first flowering date and annual soil temperature differences between transferred and original sites for different plant species