NEONATAL VENTILATION: EXPERIENCE IN SMALL PRIVATE HOSPITAL
Dr. Vikram Hirekerur D.C.H., M.D., D.N.B. *
Department of Pediatrics.*
Abstract:

Objective: To study the clinical profile, immediate outcome and morbidity in neonates requiring conventional mechanical ventilation in a small private hospital.

Methods: 31 neonates who received conventional mechanical ventilation over a period of 38 months from August 2003 to September 2006 were reviewed from their case papers. Indications for ventilation, patient profile with respect to birth weight and sex, immediate outcome including complications, duration of ventilation, late neurological outcome and cause of death if occurred were studied.

Results: Commonest indications were Hyaline Membrane Disease and Meconium Aspiration Syndrome. Overall survival rate was 90.9%. Best survival rate was seen in HMD, Sepsis and Pneumonia. 72% of ventilated patients were males. Good survival rate (100%) was seen in patients with weight between 1000-2000 gm. All 4 patients of weight 1000 gm survived. Good Neurological outcome was seen in 64.42% of the survivors who were available for follow up. Neurological complications were seen in 4 cases (14.28%). 21.42% of survivors were not available for follow up. Best Neurological outcome was observed in Sepsis and MAS followed by Pneumonia and HMD. Poor Neurological outcome was observed in Perinatal Asphyxia. Sepsis and tube block were the commonest complications. MAS and Perinatal Asphyxia required maximum duration of ventilation. Sepsis and pneumonia required shortest duration of ventilation. Cause of death was related to the disease. No child died as a result of complication of ventilation.

Conclusion: Neonatal ventilation is possible in small pediatric hospitals with good results. Patients with HMD have good immediate and late neurological outcome. Better follow up strategies are required to reduce the number of patients who were lost to follow up. Unusually high percentage of the ventilated patients were male. This appears to reflect the discrimination in the society. Future studies could focus on this aspect.
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