Conventional ventilation in neonates: experience from Saudi Arabia.

ABSTRACT

OBJECTIVE: To study the clinical profile and immediate outcome of inborn neonates receiving intermittent positive pressure ventilation (IPPV) at the neonatal intensive care unit of Civil Hospital, Khamis Mushayt, Saudi Arabia, a level II nursery. METHODS: 78 liveborn neonates who had received IPPV over a 20 months period from January 1999 to August 2000 were reviewed from their charts and nursery registers. The indications for IPPV and the immediate outcome including complications were studied with respect to various weight groups (1 kg or less, > 1-1.25 kg, > 1.25-1.5, > 1.5-2 kg and > 2 kg) and gestation groups (28 weeks or less, 29-32 weeks, 33-36 weeks and full term). RESULT: Hyaline Membrane disease (n = 31, 39.7%) and perinatal asphyxia (n = 29, 37.2%) were the major indications for IPPV. 67.9% (53 of the 78) ventilated neonates survived. The chances for survival showed a statistically significant increase with increasing birthweight (P = 0.0006) and with increasing gestational age (P = 0.002). (80%) (44 of 55) of neonates weighing more than 1.25 kg survived vs 39.1% (9 of 23) of those 1.25 kg or less, P = 0.0011. Similarly, 79.3% (46 of 58) of neonates of 29 or more weeks of gestation survived vs 35% (7 of 20) of those 28 weeks or less, P = 0.0007. The complications seen in the study group included blood culture positive sepsis (n = 7), pulmonary hemorrhage (n = 6), air leak syndromes (n = 4), endotracheal tube related problems (n = 5), chronic lung disease (n = 3) and retinopathy of prematurity (n = 2). CONCLUSION: Gestational age of less than 28 weeks and birth weight less than 1.25 kg can be recommended as the cut off weight and gestation criteria for in utero transfer in this centre and upgradation of existing facilities are urgently called for to improve the survival rates further.