Analytical study for neonates with respiratory distress on mechanical ventilation admitted to NICU - Minia University Hospital

Abstract

Introduction: Ventilatory assistance allows for the recovery and maintenance of the patient with cardiorespiratory failure. Thanks to this intervention, many neonatal patient`s lives are saved in the neonatal intensive care units (NICUs). Objectives: This study is a prospective study to analyze the rate of failure and response of management of those patients on mechanical ventilation and relation between the response of cases on MV and different studied demographic, clinical and laboratory data. Patients and methods: All neonates with respiratory distress admitted from February 2018 to February 2019.Clinical response of mechanical ventilation cases was observed. Demographic and clinical data of neonates included in the study were collected and analyzed. Results: Among of 316 neonates, 162 cases (51.26%) treated with o2 only, 28 cases (8.86%) treated with bubble CPAP ,126 cases (39.87%) treated with mechanical ventilation. The cases on MV who survived were (23%) and cases who died were (77%). Low birth weight <2.5 kg: outcome is poor for VLBW and ELBW than NBW and LBW. Small gestational age < 34 weeks GA showed higher mortality .RDS were the most common cause for usage of MV. In MV settings with initial high Fio2 and PEEP were more in died group. Sepsis, shock and pulmonary hemorrhage were most common complications and both are associated with higher risk for mortality than other complications. Conclusion: It was found that predictors of mortality in mechanically ventilated neonates concluded from this study were: low birth weight <2.5 kg with poorer outcome for VLBW and ELBW than NBW and LBW also small gestational age with poor outcome for neonates below 34 weeks GA especially with lack of use of lung surfactant in cases with RDS in VLBW and ELBW.