CLINICAL PROFILE AND SURVIVAL OF CHILDREN ON MECHANICAL VENTILATION
S Singh D*, Jain BK**, Sobti PS***, Samra SS****, Gautam A*****, Mittal S ******
DMC & H, Ludhiana - 141001, India *, DMC & H, Ludhiana - 141001, India **, DMC & H, Ludhiana - 141001, India ***, DMC & H, Ludhiana - 141001, India ****, DMC & H, Ludhiana - 141001, India *****, DMC & H, Ludhiana - 141001, India ******
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.
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