Caracterização de diagnósticos e procedimentos realizados em Unidade de Terapia Intensiva Neonatal em população near miss neonatal

Abstract

Neonatal morbidity, with its predictors and causes, are not yet well-established areas of study, and there is less evidence when compared to infant mortality. New concepts emerge to categorize and improve the outcome of newborns (NBs) with a high risk of morbidity and mortality. With ths goal, the term near miss neonatal (NMN) has emerged as a promising tool. This study aims to describe the diagnoses and the procedures conducted in NMN newborns in a neonatal intensive care unit (NICU) in a high-risk maternity hospital in Aracaju, Sergipe, Brazil. A cross-sectional study was carried out in a cohort study, which followed the first week of life of NB in the NICU, analyzing the diagnoses and performed procedures on the NBs during this hospitalization period. During the 6 months of analysis, there were 3270 births, with identification of 125 NMN children, and only one of these was not admitted to the NICU. The procedures analyzed were resuscitation, oxygen therapy, endotracheal intubation, adrenaline use, surfactant use, umbilical catheter, central venous access, venous dissection, peripherally inserted central catheters (PICC), antibiotic therapy, hemotransfusion, and parenteral nutrition. The most performed procedures were oxygen therapy, in 91.2% of the NBs and antibiotic therapy, performed in 84.7%. Among the diagnostics, 73.3% presented prematurity with low weight, 53.2% had some complication due to maternal factors and 48.4% of the children had respiratory distress syndrome. As have been reported in literature, there was found a high prevalence of respiratory disorders in this high vulnerability group, resulting in an expressive amount of oxygen therapy. The use of antibiotics and reanimation procedures were also observed above the amount described in previous studies.