Abstract Introduction and Rationale Respiratory Failure (RF) is one of the most common reasons for admission to a NICU for Critically Ill Neonates. There are considerable evidence gaps regarding the patient Characteristics, Patterns of Resource Utilization and their relationship to patient outcomes in Neonatal Clinical Practice in Resource Challenged settings. To address this knowledge gap, we conducted this study with the aim of describing the clinical outcome of critically ill neonate with RF admitted in NICU with respect to its etiology, severity and patterns of resource utilization exploring the relationship between clinical outcome and resource utilization. Methods All the critically ill newborns with RF admitted in NICU of Division of Neonatology Department of Pediatrics at B. P. Koirala Institute of Health Science (BPKIHS), in Nepal during 1year (August, 2024- July 2025) were enrolled in this cross-sectional study. The diagnosis of RF was ascertained clinically and confirmed by Respiratory Distress Score and ABG criteria. The severity of RF was graded by Oxygenation Index (OI). The numbers of resources used per critically ill neonate in NICU was ascertained and its relationship with natal and postnatal history, clinico- etiology and severity of RF and clinical outcome was explored by using descriptive and inferential statistics. Results During the study period, 126 Neonates with RF were admitted to NICU. 78(61.9%) of the newborn were of term gestation. 80 (63.5%) were with normal birth weight. The most frequent cause of Respiratory Failure (RF) was Perinatal Asphyxia (PA) in 43.7%(n = 55), followed by Pneumonia in 21.4%(n = 27) and RDS in 15.1% (19). 68(53.9%) received various forms of Resource Utilization related to the Respiratory Support. 45(35.7%) required Invasive Mechanical Ventilation (IMV), 15(11.9%) received NIPPV and 8(6.3%) received NIV CPAP. The 56 (44.4%) recovered by bubble CPAP. 40(60%) critically ill Neonates had Mild Respiratory Failure. 37(92.5%) of critically ill Neonates with OI ≤ 15 recovered with good clinical outcome. Resource Utilization by critically ill Neonates with Respiratory Failure in the NICU depended more on the Severity of Respiratory Failure and it statistically correlated with the clinical outcome. Conclusions Preterm critically ill neonates with respiratory failure utilized more health-care resources than healthy term infants in NICU Early and Proactive use of medical resources in them showed favorable clinical outcomes. In Resource Challenged Settings, the clinical decisions for Critically Ill Neonates with Respiratory Failure in NICU must be dynamic and should take in account of simultaneous evaluation of changing clinical trajectory and resource utilization. This abstract is funded by: None
Bhatta et al. (Fri,) studied this question.