Predictors of fatality in neonates requiring mechanical ventilation.
Indian Pediatr
;
2005 Jul; 42(7): 645-51
Artigo
em Inglês
| IMSEAR
| ID: sea-12249
ABSTRACT
OBJECTIVE:
To evaluate initial arterial blood gas, pulmonary pressures, pulmonary mechanics (compliance and resistance), pulmonary volumes, oxygenation indices and serum carotenoid levels as predictors of fatality in mechanically ventilated neonates.DESIGN:
Cross Sectional.SETTING:
Referral neonatal unit of a teaching hospital.SUBJECTS:
83 mechanically ventilated outborn neonates.METHODS:
83 neonates consecutively put on mechanical ventilator from March to December 2001 were enrolled in the study. The mechanical ventilator used was pressure limited time cycled ventilator with facility for online measurement of volumes and pulmonary mechanics. Arterial blood gas after half an hour of initiation of mechanical ventilation and initial pulmonary pressures, pulmonary compliance, resistance and duration of mechanical ventilation were recorded in a pre structured proforma. Initial serum carotenoid levels were also measured using spectrophotometric method. The neonates were regularly followed up for outcome. Multiple logistic regression analysis was done to find out the predictors of fatality for those variables that were significantly associated with outcome on univariate analysis.RESULTS:
On univariate analysis weight ( < 2000 g), gestational age <34 weeks, pH <7.3, duration of mechanical ventilation <72 hours, a/A <0.25, compliance <1 mL/cmH2O, fraction of inspired oxygen (FiO2) >60%, oxygenation index >10, AaDO2 >250 and serum carotenoid levels < 100 microg/dL were significantly associated with fatality in neonates requiring mechanical ventilation. However, on multiple regression analysis only FiO2, gestational age and serum carotenoids < 100 microg/dL were found to be independent predictors of fatality.CONCLUSIONS:
Initial FiO2 > 60%, gestational age <34 weeks and initial serum carotenoid levels < 100 microg/dL were independent predictors of fatality in neonatal mechanical ventilation. Even in a setting with high fatality rates, high risk of mortality in mechanically ventilated neonates can be identified.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Respiração Artificial
/
Síndrome do Desconforto Respiratório do Recém-Nascido
/
Testes de Função Respiratória
/
Feminino
/
Humanos
/
Masculino
/
Recém-Nascido
/
Carotenoides
/
Mortalidade Infantil
/
Estudos Transversais
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Indian Pediatr
Ano de publicação:
2005
Tipo de documento:
Artigo
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