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Impact of a nationwide training program for neonatal resuscitation in China

Chinese Medical Journal 2012年第8期125卷 1448-1456页

作者： XU Tao WANG Hui-shan YE Hong-mao YU Ren-jie HUANG Xing-hua WANG Dan-hua Wang Li-xin FENG Qi GONG Li-min MA Yi William Keenan Susan Niermeyer National Center for Women and Children＇s Health Chinese Center for Disease Control and Prevention Beijing 100089 China Department of Pediatrics Peking University Third Hospital Beijing 100191 China Department of Pediatrics Tsinghua University First Hospital Beijing 100016 China Department of Obstetrics Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University Beijing 100026 China Department of Pediatrics Peking Union Medical College Hospital Beijing 100730 China Department of Pediatrics Peking University First Hospital Beijing 100034 China Cardinal Glennon Children＇s Hospital and St. Louis University School of Medicine St. Louis Missouri USA Section of Neonatology Children＇s Hospital and University of Colorado Denver School of Medicine Colorado School of Public Health13121 E. 17th Avenue Mail Stop 8402 Aurora Colorado 80045 USA

Background Seventeen million births occur in China each year. Neonatal mortality is the leading cause of under 5-year-old child deaths, and intrapartum-related injury accounts for much of mental retardation in young children. The Chinese Ministry of Health sought to improve infant and child survival through a nationwide initiative to have at least one person trained in neonatal resuscitation at every birth. The aim of the current study was to evaluate the impact of China Neonatal Resuscitation Program （NRP） on policy and infrastructure changes and its effectiveness in decreasing the incidence of mortality among newborn infants. Methods The Chinese NRP incorporated policy change, professional education, and creation of a sustainable health system infrastructure for resuscitation. Multidisciplinary teams from all 31 provinces and municipal states disseminated NRP in a train-the-trainer cascade. The intervention targeted 20 provinces with high neonatal mortality and programs to reduce maternal mortality. Program evaluation data came from 322 representative hospitals in those provinces. Results Changes in policy permitted midwives to initiate resuscitation and required resuscitation training for licensure. From 2004 through 2009 more than 110 659 professionals received NRP training in the 20 target provinces, with 94% of delivery facilities and 99% of counties reached. Intrapartum-related deaths in the delivery room decreased from 7.5 to 3.4 per 10 000 from 2003 to 2008, and the incidence of Apgar 〈7 at 1 minute decreased from 6.3% to 2.9%. Conclusions The Chinese NRP achieved policy changes promoting resuscitation, trained large numbers of professionals, and contributed to reduction in delivery room mortality. Improved adherence to the resuscitation algorithm, extension of training to the township level, and coverage of births now occurring outside health facilities can further increase the number of lives saved.

关键词： resuscitation infant, newborn asphyxia neonatorum neonatal mortality in-service training, China

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Gastroesophageal manometry and 24-hour double pH monitoring in neonates with birth asphyxia

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World Journal of Gastroenterology 2001年第5期7卷 695-697页

作者： Mei Sun~1 Wei-Lin Wang~2 Wei Wang~2 De-Liang Wen~1 Hui Zhang~1 Yu-Kun Han~1 1 Pediatric Department,2 Pediatric Surgery Department,Second Clinical College,China Medical University,Shenyang 110003,China Pediatric Department Second Clinical College China Medical University Shenyang 110003 China. meis@***

INTRODUCTIONBirth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.

关键词： asphyxia neonatorum Esophagus Gastroesophageal Reflux Humans Hydrogen-Ion Concentration Infant, Newborn Manometry Monitoring, Physiologic Research Support, Non-U.S. Gov't Stomach

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