ABSTRACT
OBJECTIVES: To analyse the indications, clinical profile, complications and outcome of the babies requiring mechanical ventilation. DESIGN: Retrospective study. SETTING: NICU of a teaching hospital. SUBJECTS: One hundred and twenty one neonates requiring assisted ventilation during three years. RESULTS: Of 121 babies 59(48.76%) survived. Hyaline membrane disease (HMD) was the commonest indication for ventilation followed by birth asphyxia, apnea of prematurity, meconium aspiration syndrome (MAS) and septicemia. Infants with HMD whose birth weight was more than 1.5 kg and those who required ventilation after 24 hours of birth had better outcome. Survival rates increased with increasing birth weight and gestational age. Prolonged ventilatory support was needed for HMD (mean 117.3 hr) and MAS (mean 82.6 hr). Pneumonia was the commonest complication, followed by sepsis, air leak syndromes and intracranial and pulmonary hemorrhage. CONCLUSIONS: Ventilatory facilities must be focussed for neonates weighing > 1000 g. Assisted ventilation may not be cost-effective in patients weighing < or = 1000 g and those with complex heart diseases and other congenital anomalies.
Subject(s)
Intensive Care, Neonatal/methods , Respiration, Artificial/methods , Respiratory Insufficiency/therapy , Cost-Benefit Analysis , Humans , Intensive Care, Neonatal/economics , Respiration, Artificial/adverse effects , Respiration, Artificial/economics , Respiratory Insufficiency/etiology , Respiratory Insufficiency/mortality , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
A large number of stool specimens, of healthy newborn infants, collected from various hospitals and clinics in Bangalore City, India, have been examined for the presence of asymptomatic rotaviral excretion. Out of 370 samples analysed during a three year period from 1988 to 1991, 133 specimens (36%) were positive for rotavirus RNA. All these asymptomatic neonatal strains, without exception, showed "long" RNA pattern, but subgroup I specificity. Serotype analysis by ELISA or by hybridization with serotype-specific probes indicated that these strains probably represent a new serotype in newborn children. We find an exclusive association of human rotaviruses having "long" RNA pattern and subgroup I specificity with asymptomatic neonatal infections in contrast to the earlier observations of association of such unusual strains with acute gastroenteritis in young children.
