Outcome, Clinical Profile and Risk Factors for Mortality of Neonates Necessitating Mechanical Ventilation
Amber Naseer, Riffat Farrukh, Shaheen Masood, Sarwat Sultana, Qamar Rizvi
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ABSTRACT
Background: Assisted ventilation
has turn out to be an essential part of the neonatal intensive care unit
(NICU). It is one of the main methods of support in the ICU and undoubtedly
influences the survival of sick newborns.
Aims: 1. To investigate
common indications for mechanical ventilation in newborns 2. To investigate
factors influencing the outcome.
Method: It is a descriptive
study of 60 infants admitted to the Department of Pediatric Medicine in the ICU
over a one-year period in the department of Paediatrics, Abbasi Shaheed Hospital.
The information was gathered and analysed in a pre-designed format.
Results: Of a total of 60
infants, 46 survived, 14 died, and one infant was discharged despite medical
advice. 36 children were born vaginally, 20 were born via LSCS, and 4 via
assisted delivery. Postnatal asphyxia was the most common ventilation
indication in full-term newborns, while HMD was present in preterm infants. The
best results were obtained in ventilated infants with MAS, with 100% survival,
followed by apnoea in premature infants, perinatal asphyxia, and HMD. Pulmonary
haemorrhage (48.3%) was the most common complication among deceased infants,
followed by sepsis (28.3%) and shock (23.4%) with a significant p <0.05.
There were no complications in 76.7% of the surviving infants.
Conclusions: Among the many widely
available variables studied in this study, maximum and mean peak inspiratory
pressure (PIP or (PEEP), maximum respiratory rate, maximum mean airway pressure
(MAP) and average ventilation demand was much greater among non-survivals in
comparison to the survivors. Bicarbonate, PH and excess base have been found to
be important determinants of mortality in ventilated newborns.
Keywords: Indications, mechanical
ventilation and Results