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NEONATAL MECHANICAL VENTILATION
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XVII Annual Conference of IAP Maharashtra State (Mahapedicon 2006, Solapur, 3-5th November 2006)
Dr Atul Kulkarni, Dr S S Vaidya, Dr U R Warerkar,
Dr.Vijaykumar Gutte, (Registrar) Dept.of Pediatics, Ashwini Hospital, Solapur.
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Objectives: The study was undertaken to analyze indications, complications, outcome and factors influencing neonatal mechanical ventilation.
Methods: Prospective observational study conducted on 50 consecutive newborns during Sept 2005 to Sept 2006 who required mechanical ventilation in Ashwini Hospital NICU, a tertiary neonatal care setting.
Inclusion criteria: All patients with respiratory failure assessed by clinical and lab criteria. Clinical criteria; resp distress - Silverman Anderson retraction score 7 or>7, lab criteria - ABG score 3 or>3.
Exclusion criteria: Baby expired within 24 hours of ventilation baby with lethal congenital anomalies
Results: Among 50 ventilated babies discharge 30, AMA 14, death 6, total survival rate (exclu. AMA) is 83.3%
Various indications for mechanical ventilation:
1. |
Sepsis |
22%(n-11) |
2. |
HMD |
20% (n-10) |
3. |
Meconium aspiration |
20% (n-10) |
4. |
Birth asphyxia |
16% (n-8) |
5. |
Post operative |
14% (n-4) |
6. |
Pneumonia |
8% (n-4) |
7. |
Apnea of prematurity |
4% (n-2) |
Survival rate in specific indications:
| 1. |
Post Operation |
100% |
2. |
Pneumonia |
100% |
3. |
Apnea of Prematurity |
100% |
4. |
Meconium Aspiration |
88% |
5. |
Birth asphyxia |
80% |
6. |
HMD |
75% |
7. |
Sepsis |
70% |
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| Common Complications - |
- Septicemia (n-4)
- Anticipated tube block (n-2)
- Pneumothorax (n-2)
- IVH (n-1)
- Subglottic stenosis (n-1)
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Conclusion: |
- Sepsis, meconium aspiration, HMD, Birth asphyxia were common indications for ventilation.
- Survival rate in our study was 83.3%,
- 10 patients developed complication
- The study also reconfirms that survival rate increase with birth weight and gestational age irrespective of indication.
Application of optimum ventilatory strategy; meticulous fluid and electrolyte managements, early detection and treatment of complications improve the outcome of ventilation.
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| Last Updated on 01-04-2007
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