Objective:

To determine clinical profile of children receiving mechanical ventilation (MV) and its relation to survival in a tertiary care hospital in Punjab.

Design:

Prospective study over 18 months.

Methods:

58 children < 15 years including neonates above 2 kg were enrolled. 18 patients left against medical advice (LAMA) and were excluded from outcome analysis.

Results:

There were 9 (22.5%) neonates and 14 (35%) infants. Male:Female ratio was 5.67:1. In neonates (Group I), the decreasing frequency of primary diagnosis included perinatal asphyxia, aspiration pneumonia, MAS and sepsis. Among non-neonates, CNS abnormalities (Group IIa, 17 cases) predominated namely encephalitis, meningitis, head injury etc. Neuromuscular indications (Group IIb, 4 cases) included LGBS and OPC poisoning. Respiratory failure from increased work of breathing (Group IIc, 10 cases) included bronchopneumonia, ARDS, sepsis and CHF. Overall mortality was 32.5% (n = 13) and was maximum in newborn children (55.6%). Group II a,b,c, were associated with 17.64%, 0% and 50% mortality, respectively. Mean ventilation duration was 3.5-5.4 days in survivors and 0.3-0.6 in non-survivors (p <0.05). Laryngeal edema and VAP were noted in 19 and 5 patients respectively and none contributed to mortality. Shock, azotemia and acidosis significantly associated with decreased survival.

Conclusion:

Extrapulmonary complications formed majority of indications of MV. Shock acidosis and azotemia contributed to increased mortality.

NCPCC 2005 - Conference Abstracts.Pediatric Oncall [serial online] 2006 [cited 15 May 2006(Supplement 5)];3. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
Mechanical_ventilation.asp