Institutional Perusal of the Clinical Profile and Outcomes of Neonates Requiring Mechanical Ventilation in Intensive Care Unit- An Observational Study

Kaur R, Sodhi MK, Singh J and Sehgal N

Published on: 2024-05-15

Abstract

Background: Mechanical ventilation (MV) is one of the most important modalities used in the neonatal intensive care unit (NICU) and has become indispensable since its inception in critical care. The outcomes associated with MV remain unforeseeable.

Materials and Methods: In this prospective observational study, clinical profile, complications and outcomes of 150 consecutive neonates admitted into the NICU and put onto MV, were enrolled. Neonates which were successfully extubated >48hours and did not require re-intubation were labelled as survivors. Multivariate analysis (MVA) was done using cox regression analysis to arrive at factors having a significant impact on the clinical outcome of the ventilated neonates. SPSS version 26 was used for all the statistical analysis.

Results: Ninety-nine (66%) of the neonates enrolled in the study were males and 61 (34%) were females. Seventy-three (48.7%) of the neonates were inborn at the hospital facility and 77 (51.3%) were out born. Most of the patients were born through normal vaginal delivery (62%) and 61.3% of the patients were preterm. The median APGAR score at 1minute, 5minutes and Down Silverman score was 7 (IQR=6-7), 7 (IQR=7.5-8) and 6 (IQR=6-6) respectively. Respiratory distress was the most common indication (28%) for MV followed by birth asphyxia (26.7%). Surfactant was used in 34 patients and most common indication for its use was respiratory distress syndrome (73.5%). Median duration of MV was 64 hours (IQR=46-90). A total of 50 deaths (33.3%) were recorded in the study cohort and on MVA, the factors having significant impact on outcome were APGAR score at 5 minutes (P value= 0.006), Fraction of inspired oxygen (P value= 0.036) and presence of shock (P value= 0.037).

Conclusion: Mortality in mechanically ventilated neonates is high among patients with respiratory distress and APGAR score at 5 minutes, FiO2 and presence of shock have significant impact on survivorship.