NCPCC-16
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SSingh D, Jain BK, Sobti PS, Samra SS, Gautam A, Mittal S
DMC & H, Ludhiana – 141001, India
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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 new-born children (55.6%). Group IIa,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:
Extra pulmonary complications formed majority of indications of MV. Shock acidosis and azotemia contributed to increased mortality.
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