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Indian Journal of Maternal-Fetal & Neonatal Medicine

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Neonatal Mechanical Ventilation: Indications and Outcome

Liza Bulsara* , Bipin Rathod* , Sunil Mhaske** , Liza Bulsara* , Vishnu Kadam***

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Indian Journal of Maternal-Fetal & Neonatal Medicine 3(2):p 81-86, July - December 2016. | DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.3216.4

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Abstract

Background and Aims: Decreasing mortality in sick and ventilated neonates is an endeavor of all neonatologists. To reduce the high mortality in this group of neonates, identifi cation of risk factors is important. This study was undertaken to fi nd out the indications of ventilation and complications in ventilated neonates and also study possible predictors of outcome. Subjects: Age <1-month; mechanically ventilated; not having suspected metabolic disorders or congenital anomalies; excluding postoperative patients. Methods: Neonates consecutively put on mechanical ventilation during the study period (January 2014 to February2016) enrolled. Primary disease of the neonates along with complications present listed. Clinical and laboratory parameters analyzed to fi nd the predictors of mortality. Results: Total 300  neonates were ventilated. 52% were male. Mean age, weight, and gestational age were 21 ± 62 h, 2320 ± 846.2 g, and 35.2 ± 4.9 weeks, respectively. 130 (43%) neonates died. Respiratory distress syndrome (RDS) (31.1%), sepsis (22.7%), and birth asphyxia (18%) were the most common indications for ventilation. Mortality in ventilated patients with sepsis, pneumonia, RDS or birth asphyxia was 64.7%, 60%, 44.6%, and 33.3%, respectively. Weight <2500  g, gestation <34 weeks, initial pH <7.1, presence of sepsis, apnea, shock, pulmonary hemorrhage, hypoglycemia, neutropenia, and thrombocytopenia were signifi cantly associated with mortality (P < 0.05). Resuscitation at birth, seizures, intra ventricular hemorrhage, pneumothorax, ventilatorassociated pneumonia, PO 2 , or PCO 2 did not have a signifi cant association with mortality. On logistic regression, gestation <34 weeks, initial pH <7.1, pulmonary hemorrhage, or shock were independently signifi cant predictors of mortality. Conclusions: Weight <2500 g, gestation <34 weeks, initial arterial pH <7.1, shock, pulmonary hemorrhage, apnea, hypoglycemia, neutropenia, and thrombocytopenia were signifi cant predictors of mortality in ventilated neonates. 

Keywords: Complications of Ventilation; Neonatal Mechanical Ventilation, Predictors of Mortality. 

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DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.3216.4

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